The Use of Case Studies and Smart Device Apps to Increase Student Engagement

Sunday, 30 July 2017

Deanna A. Janz, DNP
Dept. of Nursing, Chamberlain College of Nursing, Jacksonville, FL, USA
Nicole M. Giancaterino, DNP, MSN
Nursing, Chamberlain College of Nursing, South Elgin, IL, USA

ABSTRACT: In an accelerated Bachelor's of Science in Nursing (BSN) course, e-books are available to all nursing students. In addition, an on-line progressive case study approach was used. The nursing educator also implemented a free pregnancy application (app) (among many to choose from) to engage the digital world nursing student learner with the implementation of an interactive virtual pregnancy experience. Both the free pregnancy app and the course's online progressive case studies provided a better understanding of pregnancy within a "safe" simulated client experience. The goal was to bring the obstetrical content to life and assist with critical thinking while maintaining an engaging and fun learning environment. The app engaged learning with a daily calendar on timely information on their "virtual" pregnancy, changes in fetal growth and development, and bodily changes. The app provides an interactive checklist and expert advice on everything from nutrition to relaxation, safety, common concerns, and what to expect at each visit both within the office, and once admitted to the hospital. Fetal kick counters, nutritional dos and don'ts, contraction timers, and automated text messaging brought the virtual pregnancy to life. Students visualize their baby's growth with a widget using real-world examples of fruits and veggies. Students learn the importance of monitoring their baby's movements. Nursing related safety topics in which all pregnant clients should be taught are repeatedly emphasized within each trimester of their virtual pregnancy. The learner also had unlimited accessibility to award-winning videos of their virtual baby's development in the womb to the experience of birth, virtual baby kick-counters, contraction timers and interactive case studies. Weekly text messages alerted the learner to the changes in their virtual baby as a feature of the free app. During the students immersion within the specialty area 8 week course, the course objectives and outcomes were supported with the progressive case studies and utilization of the free app to support learning both inside the boundaries of the classroom and outside of the traditional learning environment. Having the availability of the progressive case studies and virtual pregnancy experience on the home screen of their smart phone or laptop enhanced and supported the engagement of course content for the nursing student.

Purpose: The purpose of this project is to demonstrate to educators how to incorporate technology based instruction methodologies with the utilization of smart device apps and case studies throughout a nursing course.

Introduction: In a Bachelor’s of Science in Nursing (BSN) course, e-books are available to all students. In addition, an on-line case study approach was used. The goal was to bring the obstetrical content to life and assist with critical thinking and retention of information. “Zeondra” and “Arial” were introduced during the first lesson within the course case studies, who were both just weeks into their pregnancies, progressed throughout the course to complete their journey as new postpartum family unit. The instructor also implemented a free app (among many to choose from) engaged the digital world learner with the implementation of an interactive virtual pregnancy (Yu, Lin, Ho, & Wang, 2015). The free pregnancy app, provided a better understanding of pregnancy. The app engaged learning with a daily calendar on timely information on their virtual baby and body changes. The app provides an interactive checklists and expert advice on everything from nutrition to relaxation, safety, common concerns, and what to expect at each visit both within the office, and once admitted to the hospital. During their 8 week BSN course, students visualize their baby's growth with a widget using real-world examples of fruits and veggies. Students learn the importance of monitoring their baby's movements and safety topics. Weekly text message reminders alerted the learner to the changes in their virtual baby as a feature of the app. The learned had unlimited accessibility to award-winning videos of their virtual baby's development in the womb to the experience of birth, virtual baby kick-counters and contraction timers; all available on their home screen of their phone or laptop. The educator can utilize progressive virtual case-studies and a free app as supplemental methods for the digital learners of today both within and outside the classroom environment (Flood & Commendador, 2015).

Implementation: During each lesson, their online multi-cultural lives were explored. From one who was a single parent to the other who was interested in drinking extra fruit punch to make sure her fruit intake was adequate, students learned how their patients' choices would impact their pregnancies. Normal and abnormal scenarios take the students further into their patient's lives. The online interactives were developed and included in the lessons to assist the students with practicing and applying the information (Flood & Commendador, 2015). Learning how to calculate a due date, learn lab values and decide which risk factors existed for each patient provide critical thinking, active learning opportunities (Popil, 2011). “Zeondra” and “Ariel” progressed and delivered healthy babies, one vaginally and one via caesarean section. Students prepared for the birth and practiced newborn assessments.

To further peak the interest of the millennial student nurse population, the implementation of a free pregnancy app was utilized (Montenery, et. al, 2013). Each student entered a “virtual pregnancy” during the course. By providing simple registration instructions, the students entered their birth month and day as their pregnancy due date. Staggered and various gestational stages were then explored among the class population as an opportunity for student dialogue and engagement to teach the class about what was occurring during their virtual gestation. Weekly class discussions centered on the student’s virtual pregnancy and its progression. Students shared what they learned from diagnostics, nutrition, exercise, safety and myths on what to expect and how to best care for their future (real) pregnant clients in the clinical setting.

The fetal-kick count became an interactive learning moment when students were asked to apply a “kick” to the app’s tracker each time over the next twenty-four hours in which they personally experienced flatulence. As part of the app, if ten (10) kicks are not elicited over a two hour time period, an educational moment occurred. The app would alert the user to evidence-based obstetrical teaching to the virtual pregnancy student on what to do next. For example, walking, drinking a large glass of water and eating a small snack. If after another hour, less than ten (10) movement (aka flatulence) had not been experienced, the virtual pregnant participant was to now notify their healthcare provider. With active involvement by using the smart device (laptop/smart phone), an increase in responsiveness and engagement was observed. Open dialogue on their virtual pregnancy challenged the nursing students to come to class prepared and ready to share their virtual pregnancy experiences and new knowledge obtained within the classroom.

Evaluation: Despite limitations that included technology glitches for some of the interactive activities, the case study approach offered a positive, creative interactive and exciting opportunity for students to practice what they learned from their textbooks and apply it to their virtual patients and their virtual pregnancy. Students were engaged in a progression within the course via the case studies. The use of the tools on the pregnancy app fostered real-life experiences for a virtual pregnancy through safe experimentation and participation. Text messages provided for continued learning outside the classroom environment.

Conclusion/Recommendation: The inclusion of a pregnancy app and progressive course case studies provided students with an interactive and fun way to learn their maternal child concepts. To continuously improve teaching strategies, student learning outcomes, and professional growth; faculty should consider using contemporary tools that utilize technological applications to actively engage the “digital” learner of today.