Small group learning activities augment lecture content to allow safe decision making practice, and to adopt varying team roles in a simulation setting. Students practice prioritization through clinical simulation and role playing scenarios, develop leadership skills, and build insight through small group exercises. Case-based learning and role play encourages critical thinking that allows students to consider appropriate transfer of care, while retaining nursing authority, as the basis for delegation. Delegation of less critical nursing duties to a delegatee, whether unlicensed assistive personnel (UAP) or student peers, by the nursing student improves patient care through better student time management and prioritization of care for multiple patients. Delegating patient care according to accepted standard of care and agency policy, the student nurse must understand the role of unlicensed assistive personnel (UAP) to assure consistently safe patient care. Delegating appropriate tasks and procedures requires clear communication, and follow up with the UAP on assigned work is an expected responsibility of the nursing student as delegator.
Students who learn to use delegation effectively are better able to focus on more complex patient care, medication administration and patient teaching, while self-reflection on role transformation identifies personal readiness for assuming appropriate delegation responsibilities essential to safe patient care.
Purpose: The purpose of this educational intervention is to teach pre-licensure nursing students the delegation process through implementation of multi-media, multi-method approaches in the classroom and clinical setting. The nursing process is multifaceted and includes delegation as an essential attribute of the developing professional nurse. Clinical application of nursing delegation among all members of the healthcare team optimizes safety in patient care and positive patient outcomes.
Objectives:
Classroom and sseminar breakout sessions to instruct pre-licensure students the delegation process using multi-method approach strategies to include:
PPT content presentation
Audiovisual method with didactic explanation/content to provide a fundamental introduction of delegation concepts.
Kahoots game
Information Technology interactive games to apply fundamental delegation concepts to clinical situations. Interactive gaming promotes social learning and deeper pedigogical impact through use of questions
Case studies
Break out sessions to provide critical thinking opportunities and peer collaboration exercise.
Debriefing
Provide safe environment for debrief and reflection session.
Instructional Activity Description: The multimedia delegation learning experience utilized various educational modalities to disseminate fundamental nursing delegation information to pre-licensure students. The 2-hour activity was conducted prior to students entering a capstone clinical experience during their last semester. Learning occurred in both large and small classroom settings. Students were exposed to delegation material thru a presentation, Kahoot! questions, case studies, and debriefing. Details regarding content and activities utilized to engage students during the 2-hour period included: PowerPoint Presentation of fundamental information pertaining to delegation delivered in large group setting (20 minutes); Kahoot! Interactive Game of multiple choice questions delivered via online game to reinforce delegation information from presentation (15 minutes); Case Studies working within assigned clinical groups and guided by clinical faculty, students examined cases studies and applied newly learned delegation information (45 minutes); and Debriefing in large group summary of activities employing specific debriefing questions to promote meaningful reflection about delegation (30 minutes).
Outcome Expectation: Utilization of the four instructional and interactive components will increase student knowledge, skills and attitudes necessary for role transition to active clinical leadership. Following this session, in a three week clinical capstone experience students will create reasonable patient assignments using complex client health situations and will demonstrate appropriate delegation of patient care responsibilities to other senior level pre-licensure nursing students, in the context of potential urgent or rapidly changing client health situations. Peer evaluation of both leader and care giver responsibilities will ensure open and meaningful communication among student leaders and their nursing student team members.
Implications/Recommendations for Nursing Education: This instructional methodology increases pre-licensure student learning of the delegation process prior to entry into a robust medical/surgical capstone clinical experience. Educators aim to increase understanding of the student nurse leader’s role through authoritative delegation of tasks and maintaining accountability for the success of the delegation process. Components of delegation include the delegator, delegatee, and the task to be accomplished through the four teaching methods: PPT, Kahoot! Game play, Case studies, and Debriefing.