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The complexity of the nursing profession is what makes having proficient educators an absolute must. To educate future nurses, its so important to have an educator who is grounded, knowledgeable, and well-versed in their profession. According to Thompson& Sheckley (1997), there are four stable factors that provide a positive learning experience across the board; these factors include a teacher with strong organizational skills, clarifies on time, encourages cooperative learning, and promotes an active learning environment. It is also a must that these teachers, who also continue to be learners as well, develop their teaching style to be successful in their endeavors. It is important for nurse educators to encourage students to develop their critical thinking skills, which is what will guide them throughout their career. Understanding how one learns and seeking out the proper channels to enhance your own learning experience is a part of developing critical thinking skills. Critical thinking is defined as a purposeful, self-regulating series of judgments that are the results of interpreting, analyzing, and evaluating; critical thinking is a massive component in the discipline of nursing, as well as nursing education. Essential skills of thinking necessitate cognitive and meta-cognitive components of meaningful learning. Meaningful learning is one of the key objectives in nursing education, the ability to train autonomous and self-directed learners (Gholami, Moghadam, Mohammadipoor, Tarahi, Sak, Toulabi, & Pour, 2016).
Specific to nursing, there are plenty of opportunities for students to create their own learning experience instead of an educator trying to adapt to everyone’s individual learning preferences. Nursing students can practice skills in a simulation lab, educators have office hours and open email addresses for those students who feel they need extra help or explanation. Expecting an educator to cater to individual students sounds impossible and exhausting. When I entered college in 1995, I did not have all the technology and resources that are available for students today. Students can access millions of journals, articles, books, and websites in a matter of minutes with a few taps of a keyboard. A study conducted among educators in a Saudi Arabian nursing school showed that job satisfaction was high when teachers could plan and develop courses as well as being able to use a variety of teaching styles. The primary teaching styles for nursing students include theory, seminar, lab, and clinical. These styles make the most sense when you consider the skills needed to be successful in the nursing field. Nurses need to know how to read charts, be observant, implement assessment skills, listen to and give oral patient reports, and perform clinical skills. Nurse educators are also responsible for implementing evidence-based teaching and guiding students to understand the importance of evidence-based practice; if these core instructions are not met because a teacher is trying to establish individual learning preferences, it could be a detriment to patient care further down the line (Stirling, 2017). It should be up to the instructor to decide which tools and variables that they use to meet course objectives. In summary, nursing education should be a shared responsibility between the student and the teacher. However, it should be the student’s responsibility to establish their study habits and facilitating the best way of retaining and implementing the information they have been given through their instructors teaching preferences.
Gholami, M., Moghadam, P. K., Mohammadipoor, F., Tarahi, M. J., Sak, M., Toulabi, T., & Pour, A. H. H. (2016). Comparing the effects of problem-based learning and the traditional lecture method on critical thinking skills and metacognitive awareness in nursing students in a critical care nursing course. Nurse Education Today, 45, 16–21. https://doi-org.proxy-wcupa.klnpa.org/
Stirling, B. V. (2017). Results of a study assessing teaching methods of faculty after measuring student learning style preference. Nurse Education Today, 55, 107–111. https://doi-org.proxy-wcupa.klnpa.org/
Thompson C, & Sheckley BG. (1997). Differences in classroom teaching preferences between traditional and adult BSN students. Journal of Nursing Education, 36(4), 163–170. Retrieved from http://proxy-wcupa.klnpa.org/
I do not entirely disagree with you on the fact that it is not that simple. I think there needs to be a transparency of what evidence-based practices and QI projects that are being utilized in the care of the patient. There needs to be a revision of the admission consent forms to include these procedures and the possibility that the data could be used in the future to improve patient care.
I understand your point of view, but I do believe there needs to be a middle ground with the consent and transparency of policies and procedures. With the changing models of patient-organization, hospitals should take this opportunity to revise and revamp how informed consent is presented to patients. As suggested by Campbell & Parsi (2017), hospitals should try to employ a non-traditional approach to a traditional concept by expanding how information is delivered to patients. For example, while EBP and EBQI may not need to be regulated by informed consent, it should be explained to patients the there are specific practices and procedures that are being implemented into their daily care and can be used later for further improvement. As I had stated, while I do not feel there is a need for informed consent for EBQI, I do feel there is a need for transparency.
Campbell, K., & Parsi, K. (2017). A New Age of Patient Transparency: An Organizational Framework for Informed Consent. Journal Of Law, Medicine & Ethics, 45(1), 60-65. doi:10.1177/1073110517703100
I definitely agree with you on the point of delaying patient care with having to obtain consent for every individual EBP and EBQI initiative. I really feel this additional consent is over the top and unnecessary when EBP is trying to improve patient outcomes with relatively non-invasive techniques. I still stand by my initial response of supporting these initiatives to be covered under the admission consent.
I am arguing the fact that there does not need to be informed consent for EBQI projects. EBQI is systematic and guided by data collected through QI activities that are meant to build on patient safety, outcomes, and satisfaction. Patients admitted to the hospital, they give consent for treatment, and I believe this permission covers any QI projects that patients may be involved in during their length of stay. QI projects focus on solving clinical problems, which is beneficial to clinical outcomes. QI is performed by clinicians, collecting data that can improve patient care and is not as invasive as clinical research, where an individual enrolled in a clinical trial (Melnyk & Fineout-Overholt, 2015). When a patient enters into a clinical trial, where there needs to be patient involvement, such as taking new medications or having blood work done, there needs to be informed consent. It is on the contrary with EBQI; it could be unethical to withhold treatments and processes that will be beneficial to patient outcomes. For example, an EBQI project that has been in place in my ICU is the importance of mouth care in ventilated patients. The mouth care kit has a set number of swabs and chlorhexidine mouthwash for a 24hr period to be used to prevent ventilator-assisted pneumonia (VAP). Since implementing this project, there has been a significant decrease in the incidence of VAP. The difference in an EBQI project like this one versus a research project from an ethical standpoint would be the fact that in the EBQI project, there is not a control group and an experimental group.
Melnyk, B. M., & Fineout-Overholt, E. (2015). Evidence-based practice in nursing & healthcare (3rd Ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
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