In reflection of this week I have not see substantial growth in my students care plans and understanding as I did the week prior. The real test will be on Monday when they turn in their revised pieces of work. If success is not found for the students I will go back to the drawing board and revise the plan to integrate more formative assessments using Google Documents. Overall I do see growth in the students I am working some in paperwork yet mostly in hands on understanding of nursing care which is the actual goal of a Nursing Care Plan.
This week I commented on the following post
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Essential question: What evidence am I collecting for my final project and for what purpose?
To be simple and straightforward to this question: pre and post unit care plans to demonstrate increase of understanding through differentiating the presentation of the care plan process. Also journal to demonstrate students view of this implementation. The Lynchpin on which everything hinges in nursing school is the ability to create an effective nursing plan of care to implement, revise and implement to obtain an identified outcome for patient health success. My unit revolves around the ability of my students to create an effective care plan and with demonstrate understanding of the nursing process. Initial instruction earlier (prior to UbD unit) in the semester was ineffective producing poor outcomes by students submitting their idea of a care plan. The tools provided were a Nursing Diagnosis but with list of diagnosis and interventions however some students found it confusing. I found it confusing however it should have been a simple identify the problem assessed of a patient, choose a fitting nursing diagnosis from a list and then choose interventions according to books recommendation. The care plan interventions and outcomes of many were the same, some students did not prioritized according to Maslow’s hierarchy of needs, and some students submitted Medical Diagnosis as Nursing Diagnosis demonstrating lack of understanding about the differences, some simply left areas empty which identified a gap in knowledge. This is why I chose Nursing Care plans for my UbD unit. In reflection this week I must admit I see where I was challenged as a nursing instructor earlier in the semester and let this challenged attitude flow to my students. Alsharif & Qi discuss the effect of an instructor's attitude on the “intrinsic motivation and vitality” of learning (2014). The process by which the main class coordinator intended the students to learn the nursing process was through the idea of a concept map similar to the one we completed earlier in this course. The map provided had different “labels” [Key assessments, Key problems, Data, Goal, Evaluation] than the standard nursing process “labels” of ADPIE which stands for Assess, Diagnose (nursing), Plan, Initiate, Evaluate and then around the circle again. This alteration conflicted with my understanding of the nursing process and caused a challenged to my instruction and my attitude. I see where my attitude of confusion most likely contributed to a poor interest and undersigning of the idea by the students. As I talked with other cohort instructors we were all a bit confused however we worked through it. I recognized the opportunity to revise this education by using my UbD assignment to implement the differentiation of online tools and other tools to provide a different direction for the students to learn the care plan process. To overcome my challenge in scheduling I assured the students that they would be very pleased after attending this extra class regarding creating care plans. Seven of eight students attended and were pleased when class was completed by evidence of “oh now I get it”. In doing this presentation on the Smartboard it presented the ideas through use of technology in a way that was a simple process to choose, click and appropriate. The end result was a care plan. The students were able to embrace the idea and see the connections and move forward toward building and morphing their created care plan to be individualized to their assigned patient. My evidence will be a pre UbD care plan and a post UbD care plan by the same student. The process to get to the end result has taken place through one on one reflection with the student, feedback and revision by the student. One area of revision is to make the care plan more concise. I recognized the need for unit revision and increased one on one when a student came with care plan interventions a full page long typed demonstrating that they simply chose all options provided by the technology tool. Each student demonstrated understanding of how to choose interventions however the current stage is to help them prioritize. Instruction with feedback was provided for students to review their care plan interventions and be realistic to highlight ones they were able to implement and remove (cross off) the ones that they recognize as no longer effective to the client. This is part of my revised plan to promote scaffolding process. The students gained understanding of how to choose a nursing diagnosis, and that interventions needed to be chosen. The next layer is to have them identify realistically which interventions were appropriate and which were not. Alsharif, N. Z. & Qi, Y. (2014). A three-year study of the impact of instructor attitude, enthusiasm, and teaching style on student learning in a medicinal chemistry course. American Journal of Pharmaceutical Education. 78(7), p1, 7-8. Retrieved from http://search.proquest.com.proxy.consortiumlibrary.org/docview/1634222028?accountid=14473 Essential Question: What are my challenges and successes in implementing my unit?
Question 1 Guide on the side became the focus of my UbD unit. Although I have implemented various teaching opportunities I have found that many of the tools chosen for instruction necessitate feedback such as journaling and layers of revision of the care plan tool the student has provided. In the future I will create more peer to peer reviews for student growth. This will not only encourage student growth in the scaffolding of the tool it will also promote student ability to provide feedback and accept feedback which taps into a deeper level of who the student is as a person. Presentation of the various tools that students may choose from did not go quite as planned. In the future I will make it a point to become an expert in the tool use. I knew the basics of the tools yet had challenges when students ran into some problems that I did not explore. Some of these challenges were easily solved by other students who had stronger computer experience and were able to provide instruction to others who were more challenged. Challenge one--Personal lack of computer expertise: Browsers chosen for using care plan tool. The students have a choice to use Google Chrome, Firefox or explorer. The students chose Google Chrome which created the tool yet would not allow them to print the completed tool to our college printers. This is an note I have made for future unit presentations to ensure that students use appropriate browser for our college campus printers Challenge two--Student engagement: Engagement produced the need for one on one assistance to engage students who were not ready for the event of learning. Seven of my eight students attended the class. The one who did not attend was one I am very concerned about and despite reaching out and attempting to engage student they continue to remain distant to any group activity stating "I like to learn on my own". This would be ok if the student was excelling on their own however in nursing school we recognize that it is a group learning effort. Another student is actually withdrawn from the class due to grades yet attending classes to continue learning in hopes for reapplying in the future. Lastly one student was noted to be very drowsy upon arrival to class. She is a mother, wife, works and going to school. She had the heart to engage however difficulty understanding due to evident lack of sleep which was confirmed through discussion. Challenge three-- Integration into already established schedule: The unit created will be used in future classes for my nursing students however it will be part of the clinical hours and implemented much earlier in the semester. To complete these tasks of the unit I am having to flex other established schedules and do not expect full potential of the unit for this presentation. I do expect it has and will meet the final product goal of a completed Individualized nursing care plan yet I do not expect it will produce the in depth processing intended along the journey. Question 2 Planning Due to the units need for integration into existing schedule this posed a great challenge to my ideas. Nursing school is intense on its own and I felt a bit poorly about adding much more to the current load. I sought out something that the students could use assistance on and discovered that most of them were really struggling with creating individual nursing care plans on paper. There are tools in multiple books that simply needed to be tapped into. Upon assessment of how many students had explored their textbook online tools 7 out of 8 said "No". This assessment is what directed me for the topic of my unit. To prepare for teaching I had to personally explore the tools enough to be able to teach the students. This took time both in gaining access and understanding how the tool worked to meet the needs of the student. Once this was complete I set up the class which had very little warning--5 days. Finding a day and time that worked with their clinical hours, classes and work schedules on such a short notice was intimidating. A time was chosen prior to their regular class time simply asking them to come in 1.5 hours earlier. This was successful with exception to previous individual student challenges state earlier. Other activities are seen as easily incorporated into the current schedule with some adjustment to topics or reflection. Question 3 demonstration The idea of this unit is to ensure that students are able to create an individualized care plan for a client they have chosen during their clinical rotation. The students have begun to thrive with the newly implemented tools as evidence by student having a completed care plan at our last clinical rotation. Feedback was provided and students were instructed to revise plan accordingly to the criteria provided them. This is part of the scaffolding plan of learning for this unit. Next week they will bring a revised care plan which I will provide more feedback on for further revision. Overall this unit is working yet I am finding challenges to implementing the deeper personal growth throughout the process of learning due to time constraints. In reflection of this week I see growth in myself and my students. The once ambiguous nursing care plan creation has become a focused experience through implementation of the created UbD unit. Although the created unit has been challenging to implement to its fullest potential I see growth of understanding and success in my students attitude toward the idea of creating care plans which did not previously exist. The one challenge I have is how intensely I care about my students success. As adults they are more set in their ways that may have been created by adverse childhood experiences affecting their brains ability to see things or focus as needed for success. I have three students that not only demonstrate this yet have also confirmed it through discussion and relationship. These students definitely drive my desire for differentiated learning to see their success. With this focus it overflows to the other students providing various ways to attain the same goals of understanding. I am excited for refinement of the created unit and implementation with future cohorts. I believe that what has been presented has encouraged my students to success and the importance of looking at their online tools provided them.
This week I commented on Gerald, Jim and Heathers blogs. It is so exciting to see us all growing. Gerald implemented clickers and Jim discussed overcoming the challenges and performing a pre-assessment that showed the variation of his students level of comprehension and beyond. Heathers site is most special to me as I was in her class last semester and clearly understand the changes she is implementing. Unaware she is an example to me of the humility it takes to be a teacher. To be open to revision to a plan that we may have initially thought was a "perfect" module. Thank you. As I move toward the finish line of this class I reflect on this final project. I am excited to use the tools learned to implement interactive classes that meet students where they are as humans. Although this may be more challenging in larger classes I will overcome the challenge when it arises as I know will be well worth the time. To ensure that students are excited to come to class and excited or at least not lethargic toward the idea of learning. I see the students "glaze over eyes" when instructors simply become the "Sage on the stage" instead of a "guide on the side" (Morrison, 2014). I have learned from my peers as well. The continued discussion with Mariah of flexibility and how important this skill is as an instructor. Also how important as we learned in our brain based learning to engage students for the opportunity to teach those skills that are not inat to the brain. The ability to demonstrate flexibility and encourage our students to also demonstrate flexibility will give them tools for the future.
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Rachelle White
This is my differentiating instruction through technology blog site. Archives
April 2017
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