Learning Objective #1: Describe an innovative tiered discussion strategy using in-class and online components as a vehicle for sustained reflection

Learning Objective #2: Describe how tiered discussion was successfully used in a graduate nursing theory course creating opportunities for students to grasp, understand, manipulate, and apply theory

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To develop the necessary critical thinking and evaluatory skills at the graduate level students need to approach coursework openly, draw from their own experiences, and exchange ideas in order to learn how to grasp, understand, manipulate, and apply knowledge. To do this graduate nursing educators must develop and employ educational strategies to promote reflection and sharing. Reflection and sharing of experiences and opinions promotes discussion beyond the course objectives, creates opportunities for understanding, sharing, critical thinking, problem solving, and social interaction especially when students have substantial foundational nursing experiences to draw on, as graduate nursing students often have. In an attempt to enhance sharing and reflection a pilot test of an innovative tiered discussion strategy, using the Socratic method in-class and a discussion board online, was incorporated in a one quarter graduate nursing theory course. Socratic method is most effective for discussions which aim to explore underlying structures or competing hypotheses, and was used as the first discussion tier to demonstrate the complexity and uncertainty of nursing theory. As the second tier an asynchronous online discussion board was designed to allow students time to reflect and respond to the discussion begun in class. Seventeen graduate nursing students with a mean age of 41 (27-57) and mean years of practice of 14 (2-31) participated in the tiered discussion and evaluation. A nine item evaluation survey demonstrated that the tiered discussion strategy was highly effective and valuable for the students. An assessment of the online discussion entries found multiple examples of understanding, sharing, critical thinking, problem solving, and social interaction. The tiering of discussion in this course increased the sharing of thoughts and facilitated both cognitive and professional growth for the students. Innovative reflection strategies should become the gold standard for discussion in graduate nursing education.