The goal of this teaching strategy is to engage students to be critical thinking nurses, understand the nursing process and its’ application to clinical practice.
Methods: Colleges of nursing recognize and understand that it is not enough to cram nursing students with knowledge; instead, students must learn to be critical and reflective learners, able to work in teams and deliver high quality nursing care. Faculty consistently struggle to identify new learning strategies to reach these goals. Recognized as a problem solving and critical thinking tool, the nursing process is the method most utilized by nursing schools and colleges.The transition to becoming critical thinkers in first year nursing students is one that can present many challenges. Faculty in the first sequence medical surgical course sought to introduce an innovative method to help students conceptualize critical thinking in the nursing process. With assistance from the university, the instructional technologist helped design the sunflower diagram. The concept included utilizing the sun as the pathophysiology of the disease and four petals of the sunflower each representing the nursing process. At the center of the sunflower is the problem or patient complaint. There are also two leaves to represent special considerations and complications. A nursing diagnosis is given to the nursing students and they are then challenged using a backwards design to create a case scenario. They then would fill in each petal based of the findings and recommendations for the nursing diagnosis. Students discuss the pathophysiology in the sun on the sunflower template. In the assessment petal, students placed the data of the assessment findings that would be appropriate for this patient. The plan petal included SMART goals indicating both long and short-term goals for their patient. The interventions petal included individualized and appropriate nursing actions for the patient. The evaluation petal determined if the plan of care needed revision or if it was successful. In the leaves along the stem, students added possible complications as it relates to the diagnosis. The special considerations petal related to the patient’s social, ethnic, cultural, and financial concerns
Results: All first sequence-nursing students received an anonymous online evaluation as part of a quality improvement project evaluating this teaching strategy. The evaluation assessed how the use of the Sunflower diagram helped facilitate their learning and critical thinking.The survey requested comments on four items: “I felt the sunflower assignments helped facilitate my learning”, “The critical thinking group activity helped facilitate my learning”, “Was the explanation of “how to” do the sunflower clear?” and, “What suggestions would you make for improvement if any?”
Conclusion: Of the 276 students enrolled in the course, there were one hundred and nine responses.Sixty-six percent of the students surveyed reported that the sunflower critical thinking activities facilitated learning in and outside of the classroom. These critical thinking exercises helped students to think outside the box and look at improving the patients experience through the nursing process by providing patient and family centered care and utilizing teamwork and collaboration.