Student Learning Experiences in a RN-BSN Capstone Course

Purpose and Background: Nursing capstone courses provide an opportunity for senior students to integrate their liberal education with nursing knowledge in a meaningful educational experience that results in higher level understanding, expanded knowledge base and clinical skills, and a sense of growth and accomplishment (Rebeschi & Aronson, 2009). In anticipation of graduation, the capstone course enables a one-on-one precepted experience that can help the student transition into the graduate nursing role, practice leadership activities, and provides program and student assessment and evaluation opportunities.  

In an online RN-BSN program in upstate New York, the capstone course is a comprehensive, accelerated, and intensive seven-week class and clinical experience that completes the nursing course sequence.  It builds upon prior learning, incorporates critical thinking and reasoning skills, reflection, and fosters independence in practice as students develop their own individual projects in healthcare settings for a 45-hour guided practicum, conducted over seven weeks.  Facilitated by a clinical preceptor and course faculty, students create learning objectives, activities, and plan evidence of their accomplishments by designing an individual learning contract to map out the experience. Weekly, students assess how they met their objectives, evaluate outcomes, have guided reflection, and submit evidence of work products. Student presentations and a final analysis of their learning contract completion, using audio screen capture, culminates the course.

While student learning outcomes are achieved, students often approach the capstone with concern and anxiety over the unknown (Kerr, Hemmings, & Kay, 2013). Data from course evaluations, student-faculty communications, and anecdotal reporting indicate student’s concern and stress when planning their individual practicum projects and feelings of being overwhelmed by the intensity and expectations of the course.  Faculty engage individually with students and provide support, but there remains perceived student stress.

In order to provide a more positive learning experience, this study is collecting data on student’s experiences, perspectives, reflections, and suggestions for how the RN-BSN capstone course experience can be improved. The data will become part of the annual program assessment process and will have direct impact on course revisions and improvements.

Methods: The study design is a retrospective qualitative, using content analysis. Following informed consent, student demographic data are collected by e-survey. Focus groups of 3-5 students, who have successfully completed the capstone course, are facilitated by the co-investigator, who are faculty currently teaching the course. The anticipated sample is 9-20 students, until data saturation is reached. The groups meet for one hour, via a virtual web conferencing platform, using audio and video components, and interviews are recorded for subsequent analysis of transcripts.  Using a semi-structured interview guide, topics include student’s experiences in the procedures, course assignments, methods, and procedures of the course, and ideas and suggestions for possible course revisions.

Results: The study is currently in progress, and will continue until data saturation is reached. Data will be analyzed by the co-investigators, who will independently review and analyze transcripts from the focus group sessions. Tentative categories, using step-by-step deduction, will be developed. Categories will be coded and revised until they can be reduced to main categories, using formative and summative checks for reliability. Data verification will occur with students, as needed.  Finally, themes will emerge that describe the student experience. Data will include student feedback on experiences with specific assignments, course procedures upon entering and throughout the course, and concrete suggestions for course improvements, both in content, course delivery methods, and faculty and preceptor facilitation. Results will be integrated into the annual program assessment, and will contribute directly to course revisions.

Conclusions: The capstone experience enables students to practice independently (Jukkala, Greenwood, Motes, & Block, 2013), yet there is concern over student feedback on their anxiety and unfamiliarity with the independent nature of project planning. Consistent with outcomes for student success and satisfaction in their accomplishments, this study can help to provide insights into how to improve the course experience and contribute to student success. Incorporating student’s feedback, experiences, and perspectives into program assessment provides a richer and more comprehensive foundation upon which to improve the teaching and learning process, positively impacting the student’s practicum experience and transition to professional practice.