Background – There are not many opportunities for an undergraduate nursing student to participate in hands-on, critical care. A flipped classroom is a developing pedagogy with opportunities to bridge the education – practice gap in nursing education. It allows class time for active learning and lecture material to be assigned before class as homework. A flipped classroom approach has potential to engage nursing students to address the needs of students and the complexity of health care today. Collaboration, active, and team-based learning are all important strategies in a flipped classroom model that provide students necessary skills and competence to work in the practice environment. Nursing faculty are responsible for ensuring students acquire the knowledge, skills, and confidence necessary to support a novice nurses’ clinical practice. Insufficient experiences may make it difficult for student nurses to obtain the experiences that are needed to build confidence in caring for critically ill patients. With the use of innovative classroom strategies and simulation, nursing students can become better prepared with knowledge, skills, and confidence in critical care nursing.
Methods - A critical care elective course was offered to students of a traditional baccalaureate program. This course aimed to expose the students to the critically ill patient in the intensive care unit (ICU) environment and to introduce skills that the students may not have the opportunity to engage in during their clinical hours. Led by two faculty with critical care experience, this course used multiple learning techniques including high fidelity simulation, didactic teaching, online discussion, and reflective writing to teach critical care concepts and entry-level skills. A “14-bed” ICU atmosphere was created through re-arranging the classroom furniture, assigning the “staff” (students) a patient assignment, and providing “patients” (dolls) for the students to care for during the class. A handoff tool, which was adapted from a local ICU, was used to take daily report on a case study patient. Content was presented by the faculty with emphasis on the critical care nursing management of advanced hemodynamics, ventilators, ICP control, and sepsis. Once the content was reviewed, faculty assumed the role of the ICU provider and “rounded” with the students. Patient issues were identified by students through the use of a Daily Goal Tool, which was adopted from a local ICU. Using innovative technology of the Simulation Center, students were able to participate in a high fidelity simulation while the remaining students actively observed the simulation through live-streaming technology. Active observers were given checklists which were specific to the case study and focused on areas of safety, communication, and skills. Knowledge was measured through multiple modalities.
Results – At the conclusion of the 16-week, semester-long course, student evaluations reflected the time spent in simulation had increased the student's confidence. Student evaluations also provided feedback stating simulation was a learning modality which brought to life the importance of critical care nursing and was a great way to understand advanced nursing concepts without a designated clinical rotation.
Conclusion – In the times of difficult clinical placement, using evidence-based practice, bringing the ICU to the classroom is an innovative and pragmatic approach to undergraduate nursing education for those interested in pursuing critical care nursing.