Clinical Application of Authentic Learning Experiences for On-Line RN Students

Background: As schools of nursing move towards an online format to meet student needs, desires, and expectations, it becomes difficult to provide authentic and affective learning experiences that can readily apply to “real-world” clinical practice problems. Authentic learning is defined as the ability to solve everyday problems through application of classroom education to the actual practice environment. Affective learning addresses emotions, feelings, values, and attitudes, all of which are difficult to teach in an online environment. In the case of nursing students, authentic learning involves taking what is learned in school and applying learning at the bedside. Affective learning allows students to learn from and apply the emotional aspects of nursing care to patients at the bedside. Providing authentic and affective learning opportunities for RN students is a challenge faced by nurse educators and requires creativity and imagination in the design of online classes.

Problem: Creating an online course in oncology nursing for students, primarily coming directly from an Associate Degree program into an RN to Bachelor of Science Degree in Nursing, presented a challenge for faculty. To establish an interactive, robust, and interesting learning environment, faculty needed to offer a variety of opportunities to engage students in authentic and affective learning, which could be readily applied to clinical practice.

Approach: Rather than purchasing a textbook, students access a variety of current online evidence-based websites used by actual professionals caring for patients with cancer as well as peer-reviewed journal articles. Throughout the course, emphasis is placed on the concept of the collaborative interprofessional team tasked with managing the care of the patient with cancer. Course content includes multiple authentic learning opportunities such as case studies, videos presented by healthcare professionals on radiation oncology and central lines, student videos of cancer prevention education, and quizzes attached to online presentations and scholarly articles. To facilitate affective learning, online activities were implemented to include group discussions regarding actual lived experiences of death and dying and reflection on thoughts from a six-part video journal of one patient’s journey with cancer.

Outcomes: Following completion of the online course, students selected one concept or example learned and applied this new clinical approach to their own practices. Students then discussed with their classmates what concept or example was chosen, why it was chosen, and the outcomes noted from the application. Student feedback overwhelmingly supported the authentic and affective learning opportunities built around clinical practice application, especially from the video journal provided by a patient with cancer.

Conclusion: Authentic and affective learning opportunities, especially those focusing on the lived experiences of a patient with cancer, are described in student feedback as being readily applicable to clinical practice. Students described their increase in knowledge and recognition of patient values regarding cancer diagnosis, cancer treatment, unintentional consequences stemming from treatment, and the emotional aspects involved in caring for patients with cancer.