Quality and Safety in Nursing Education: Integrative Learning Strategies to Promote Clinical Decision Making

Mauro, Ann Marie P.

Wednesday, July 13, 2011: 10:30 AM

Ann Marie P. Mauro, PhD, RN, CNL
College of Nursing, New York University, New York, NY

Learning Objective 1: Describe integrative learning strategies to enhance students’ clinical decision making and promote quality, safe care with improved patient outcomes.

Learning Objective 2: Discuss challenges to implementing integrative learning and recommendations for overcoming them.

Background. The Institute of Medicine (2010) has called upon nurse educators to keep abreast of a rapidly changing knowledge base and new technologies to better prepare the workforce and to provide quality, safe care and improved patient outcomes. In the face of a faculty shortage and increased enrollment demands, nurse educators must develop innovative teaching strategies to promote clinical decision making through integrative learning. The project purpose was to implement integrative strategies in large enrollment courses to achieve these goals.

Methods. The setting was a research intensive university with an undergraduate enrollment of 860 baccalaureate nursing students. Integrative learning strategies, including unfolding cases and clicker technology, were implemented in adult health nursing and pharmacotherapeutics courses. High fidelity simulation alternating with traditional clinical experiences was used in the adult health nursing course using an A-B model. Traditional and accelerated second degree students were included. Didactic classes ranged from 119 to 171 students, simulation groups had 12 students, and traditional clinical groups had 6 students. Prioritization, quality care, patient safety, and use of best evidence were emphasized in didactic discussions, simulations, and clinical experiences. Integrative learning within and between the two courses was incorporated. Collaboration among faculty occurred to achieve improved student outcomes.

Recommendations. Educators can bring their course content “alive” by integrating problem-solving activities, simulations, and clinical experiences to assist students to develop decision making skills. Students must be engaged and challenged to actively participate in their learning, especially in large enrollment classes. Collaboration among course faculty is essential. New technologies, such as podcasts, are also recommended to enhance students’ understanding of key concepts. Faculty must help students make the connection between the classroom and clinical in order to provide quality, safe patient care. Challenges include class size, level of student preparation, and faculty teaching experience. Ongoing curriculum review is encouraged.

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