In my 15 years as a nurse educator, I’ve found that the flipped classroom learning environment provides an ideal way for new nurses to practice good habits. They learn to talk about their patients and in turn gain confidence in their application of the knowledge they are learning.
Positive habits breed positive outcomes
The best part is that new nurses develop the habit of looking something up if they don’t know the answer. I encourage using the reference tools that are available in their unit. This way if the hospital uses a specific application for medications or procedures, the nurses use the approved tool.
Here are my top ways to engage learners in the flipped classroom and help them practice good habits:
- Ask learners to bring one thing to the class that they learned while caring for their patient and be prepared to share it with the other students
- I’ve had students bring and share information about a new medication, a wound dressing technique, ventilator settings, hemodynamic monitoring data, delirium prevention tips, etc.
- Require learners to come prepared to give report on their patient
- The novice nurse only needs their report sheet, but if they have access to the electronic health record in the classroom they can also use that to discuss patient care. HIPAA rules apply, so what is discussed in the classroom, stays in the classroom.
- The nurse starts giving report on their patient, and that’s where the educator can model facilitating with some questions. This role modeling also prompts the other students to ask questions. The nurse giving report is not required to answer, to avoid putting that person on the spot. The responsibility to provide the answers lies with everyone in the class. This way they are all engaged and learning. Some examples of questions to ask:
- “Why is the patient on both vasopressin and norepinephrine?”
- “What do these medications do, mechanism of action, etc.?”
- “What are the normal rates of infusion? How do you titrate? Which one do you titrate first, etc.?”
- Guide the discussion and have students offer support and feedback to their peers
- Your role in the report exercise is to guide the discussion. Ask targeted questions regarding rationale for answers the students have provided AND encourage the entire class to contemplate and provide answers. If the class doesn’t know the answer, give them time to look up the answer and have them share it. This procedure organically allows the students to explore and learn in a safe environment. You are modeling a positive and collaborative way to problem solve. By the end of orientation, the students will begin to emulate this approach.
- The students’ role is providing feedback. One of the things I also love about this type of sharing is the ability of the peer group to offer support and feedback on a job well done. During one class discussion, a nurse talked about a particularly difficult day, where a patient with sepsis kept declining, and no matter what evidence-based intervention they performed, the patient did not stabilize. The nurse providing the report told the peer group that he felt awful about his role and that he felt he did not do enough for the patient. I asked the class to identify positive interventions that the nurse did and give him that feedback. The class identified over 20 interventions the nurse performed to make a difference for the patient. The nurse who had previously felt poorly about his effort now saw the good he had done. He left the class that day with a different perspective on the care he had provided. How uplifting!
- Provide classroom time for the nurse to share an error they made
- This one is tricky and needs careful preparation in order to be successful. First, the nurse who made the error must be allowed to opt out of sharing. They need to feel safe and supported in sharing what happened and what went wrong. If the nurse agrees, it is helpful for both the nurse to share and the peer group to hear, so they can all learn.
- AACN has an excellent webinar “Support for the Second Victim: Caring for Our Own” for more ways to support the nurse who makes an error.
- Bring a prepared case study for learners to review in a group
- Depending on the size of the class you could have several different case studies with questions the nurses need to answer, and then they can present their case to the rest of the class. Everyone learns from each other.
- This one is important because inevitably not all students are going to come prepared to give report or share something they learned. As an educator, be ready for those issues by having prepared case studies for the class to keep the flipped classroom concept moving forward.
Most of these tips don’t require extra preparation on the part of the new nurse, which is great, because we know their orientation is already jam-packed with assignments and things to learn. The best part is that these tips keep nurses involved, invested and taking part in their own learning.
Share your favorite facilitator tips
To my fellow educators: It’s a tough job and you’re doing great! I know you have special ways to engage, involve and motivate your learners. Or maybe you have something to add or ask. Please share your questions and ideas for providing progressive and critical care nurse orientation.
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