Engaging Students to Clinically Think: Preparing Practice-Ready Nurses

Description/Overview: An urgent call for transformation in education was recently issued based on research findings from the Carnegie Foundation, Macy Foundation, Robert Wood Johnson/IOM, the Lancet Commission, and QSEN. Research, currently validated by everyday experience with new graduate nurses, clarifies that the traditional pedagogical strategies of lectures and multiple-choice tests fail to adequately educate or assess graduating professionals for a practice. Graduates do not know how to clinically think and reason, so safe care of patients is not possible. These traditional methods succeed in helping learners acquire knowledge – vast amounts of knowledge. However, they fail to prepare new graduates to USE critical knowledge appropriately and as needed when caring for patients. The education-practice gap continues to widen, to the point that extensive and expensive residency programs are now mandatory to prepare new professionals to become clinically safe enough to practice. Learners convey that they generally do not prepare for class by completing the extensive reading assignments, in part, because faculty bridge the learning gap. Students reveal that teachers bridge the gap by 1) lecturing on the content deemed important, 2) sharing their PowerPoint presentations, and 3) testing primarily on that content. The result is passive learners who enter practice without a solid basis for and understanding about how to integrate theory into practice. Being practice-ready means gaining all essential knowledge but, as importantly, knowing how to use that knowledge in the right patients and at the right time. Teaching for a practice therefore requires a strong foundation in the sciences but also requires that faculty coach learners’ thinking and use of that general knowledge from the sciences into specific patient situations (in a context), if it is to be remembered. This imperative calls for change in pedagogical strategies and engagement by learners to use knowledge as they gain it. This session will explore new pedagogical methods that engage learners to become active participants in a lively classroom, provide clinically relevant content, compel the development of clinical thinking and reasoning, and support educators to coach the use of knowledge in specific patient contexts. The first method provides learners with salient, clinically relevant content that better prepares them to clinically think according to the logic of clinical practice rather than the logic of theory. Second, the incorporation of simulated, unfolding, and unprompted cases allows learners to immediately use the knowledge gained by problem-solving authentic patient situations. Using knowledge to problem solve promotes learning to think like a nurse. Third, small group discussions engage learners to think and reason about authentic and common clinical and complex issues that occur in specific patient situations. The in-class challenges provide faculty with opportunities to coach learners in their development of clinical thinking in the context of real patients issues. Making it possible for learners to think and act like a nurse prior to entering practice better prepare then to become practice-ready nurses. To support pedagogical changes, innovative resources that can assist educators to integrate the major research findings and improve engagement and clinical thinking will be examined.