610 Project(4.27.08)

Observation and Critique Running head: OBSERVATION OF EDUCATOR

Observation and Critique of a Nurse Educator Aaron A. Almassy Ferris State University

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Abstract The student from Ferris State University (FSU) attended an adult assessment class at a local college, in order to observe and critique the teaching methods of the instructor. Key topics include examination of teaching methods/class sequence, critique of the instructor, evaluation of course materials, and a critique of the student evaluation tools. Each topic addressed will include the class session as the sub-topic. Finally, a conclusion is presented which consolidates the student’s findings.

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Observation and Critique of a Nurse Educator The purpose of this project was to observe and critique a professional nurse educator in his or her classroom, and to report the findings. Arrangements were made with S.M., RN, BSN, MSN, FNP, the director of a local college nursing program. Observation of the lecture portion of the basic adult full body assessment and the associated nursing laboratory portion as well. The lecture and laboratory portion focused on the neurological assessment including examination and testing of the eyes and cranial nerves. SM was assisted by the school’s nursing laboratory assistant, also a Registered Nurse (RN). A critique of teaching methods and materials was performed and is presented. Teaching Methods/Class Sequence Class Session: Theory SM chose the lecture method, while making use of a teaching standard—the Microsoft power point presentation. The skillful instructor will provide means other than oration to convey the necessary information (Bradshaw & Lowenstein, 2007). The proven method of lecture can be valuable to students. As Bradshaw & Lowenstein (2007) state, when one’s goal is to impart basic facts, establish concepts, or to show passion for a subject, the lecture is a functional method to use. The class was arranged as one might expect when thinking of a college classroom. Large eight foot long tables were used allowing room for three students per table. The tables were arranged so that all students were facing the instructor, and so that all students could effectively view the power point presentation as well. Overall the session lasted an hour and half with a 10 minute break provided near the middle of the lecture. SM stood at the front of the class providing a substantial target for the students to view. She did not just stand at the front of the class however she changed positions frequently as well as provided for many instances of eye contact with all sections of the classroom. The lecture provides for many advantages including, providing the instructor maximum control, poses minimal threat to the instructor and the student, it encourages and permits deductive reasoning (Bradshaw & Lowenstein, 2007). While presenting as a dynamic speaker, SM used the expository lecture form. The expository lecture is

the most common form of lecture (Bradshaw & Lowenstein, 2007). In this format, SM did most of the talking, while entertaining few questions and examples from the students. There are of course, disadvantages and potential problems associated with the lecture method as well. A few examples of these are, potential boredom, and decreased knowledge retention. As Bradshaw & Lowenstein (2007) state, “…80% of information gained by lecture alone can not be recalled by students 1 day later, and that 80% of the remainder fades in a month” (p.127). It is important to recognize that the lecture method is neither good nor bad, like any teaching method it is more efficacious when combined with other instructional strategies (Bradshaw & Lowenstein, 2007). Class Session: Nursing Laboratory The coinciding adjunct teaching strategy is the hands-on method, which is utilized in the nursing laboratory. In this session, motor skills combined with information learned in lecture are practiced and refined as the student attempts to attain adequate skill level (DeYoung, 2003). The instructor’s role in this teaching method is to orchestrate and or to supervise this practice. Practice is crucial to cement the sequential order of operations in the student’s memory (DeYoung, 2003). Repetition is an important concept here; repeated rehearsal of the information/demonstration is a key to knowledge retention in the short term memory. Additionally, repetition helps the new short term memories continue long enough to transition to long term memories (Billings & Hallstead, 2005). During the practice session, the students were allowed to self-select into small groups to facilitate the learning experience. SM and the laboratory assistant circulated between the two adjacent laboratories fielding questions and providing examples of how to perform the various procedures. Students were practicing the assorted components of the neurological examination on this particular day. One area of concern for students was testing of the cardinal fields of gaze. Another area of concern was how in-depth they needed to perform the examination of the eye. Both SM and the laboratory assistant were helpful in demonstrating the procedures for the fledgling students.

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Critique of Instructor Class Session: Theory A critique of the instructor and her teaching methods was completed. The instructor’s use of the lecture is fairly standard, and was expected, especially after viewing course materials. SM conducted the lecture well displaying her vivacious personality and the extensive knowledge that she has regarding the topics. SM controlled the room during the lecture, used enthused mannerisms, and avoided the use of monotones. Bradshaw & Lowenstein (2007) believe that showing enthusiasm is a key component of delivering an effective lecture. They go on to indicate that the use of podium is a barrier in the presentation of the lecture (Bradshaw & Lowenstein, 2007). There was a podium and table in the front of the room for SM to utilize for handouts and other necessary items for the class. However, she spent the majority of the time lecturing not from behind the podium, but while moving about. The use of movement is a key to breaking this physical barrier separating the instructor from her students (Bradshaw & Lowenstein, 2007). She addressed each section of the classroom by making eye contact. Additionally, she called on several students by name to perform examples of small procedures or offer thoughts on the topic. Bradshaw & Lowenstein (2007) state that one should speak to the right half of the audience and the left half of the audience, and that the instructor should never turn his or her back to the audience. Topics of the lecture included: •

components of the mental status examination

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structure and function of the eyes

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physical examination of the eyes

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cranial nerves associated with the eye

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pupil response

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nursing diagnoses related to the eye

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structure and function of the central nervous system (CNS)

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CNS health history and physical examination

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all cranial nerve function, structure, and physical examination

SM used humor appropriately throughout the lecture from illustrations within the Power Point presentation to the ad-lib usage of humor throughout the session. This utilization of humor was viewed as positive, as it increased the lecture’s appeal and maintained student attention. Parrott’s study (as cited in Billings & Halstead, 2005) presents the advantages to the utilization of humor in the classroom. These include an increase in the students’ attention, establishment of student/teacher rapport, decreased stress levels, motivation of learners and creation of positive attitudes within the students. The approach was effective as it was observed that the students were actively engaged in the lecture and attention seemed very well maintained. Finally, SM utilized the method of demonstration on a limited basis during the lecture. For example, SM demonstrated the procedure for performing evaluation the six cardinal gazes to the class. The usage of these mini-presentations will be especially useful for the visual learner, as these individuals learn best by demonstration (Cuyamaca College, 2003). Students however were not prompted to ask questions nor were many questions directed to the students. This lack of questioning did not provide for optimal development of critical thinking skills. The lecture provided for focus on the cognitive domain of learning as students increased their level of knowledge and comprehension of the material presented (Billings & Hallstead, 2005). Class Session: Laboratory The laboratory session was structured more informally than the lecture. First, the students were gathered for further introduction of the neurological examination, including further in-depth presentation of the skills to be acquired. As we know, the demonstration is especially important for the visual learner, as it is equally important to all nursing students. Students were encouraged to interrupt to allow for clarification and questions. Questioning by the instructors was used to reinforce prior learning and for the development of critical thinking skills (Bradshaw & Lowenstein, 2007). This technique was especially evident in the beginning of the laboratory session as SM and the laboratory coordinator reviewed some brief clinical experiences with the students as related to the nursing laboratory. Students were being questioned as to their

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experiences and perceived abilities at performing certain aspects of the nursing assessment. As some students were sharing their experiences, other students were beginning to make correlations to their own experiences, providing evidence of critical thinking. During this portion of the class, students were taught how perform the various components of the adult neurological examination. Specifically, the six cardinal gazes, the Snellen chart eye examination, pupil response, elicitation of the cranial nerves, the Romberg test, and others. The students were then allowed to self-select into groups of three or four members and begin to familiarize themselves with these techniques. Students were given the check-off procedure lists to go along with these specific competencies; to help focus their learning efforts, as well as to make clear expectations for the return demonstration evaluation process. Students were guided by the instructors as appropriate. The instructors circulated throughout the two adjoining nursing laboratories spending time with each group individually. Provision of one-on-one interaction with the instructor allows for personal attention that otherwise would not necessarily occur. These contacts with the instructor allow students to ask questions more openly within the “safe confines” of their group. The student is not intimidated by what he or she may consider a “stupid question”. Observation of this activity was witnessed several times as students encountered unexpected situations or results during their practice session. The Laboratory session focused on the psychomotor domain of learning. This is because of the acquisition and use of manual skills that are associated with nursing assessments (Billings & Halstead, 2005). Evaluation of Course Materials Class Session: Theory First of all, a skeleton outline of the power point was given. Only the main points were given on this outline, promoting further engagement of the student. The student must be more fully engaged in order to take notes that will be important to review later. Bradshaw & Lowenstein (2007) indicate that a skeletal outline should be given to students only if helpful for students’ identification of key points. This method of providing only the main points also encourages active listening throughout the lecture. Active listening promotes keeping the

attention of the audience which is a main goal when using the lecture format. According to DeYoung (2003), studies have shown that the concentration level of students rises to a climax at approximately 15 minutes, and steadily decreases until the end of lecture. Since the lecture dealt with the neurological examination, other assorted materials were handed out. One handout focuses on the cranial nerves, providing an alternative to a mnemonic by using a drawing with numbers to increase visual stimulation and associative learning. Another useful handout was the Mini-Mental State Examination (MMSE) and an explanation of the tool. The full explanation of the tool is essential to understanding what the results signify. Additionally provided was the Department of Veterans Affairs (VA) mental examination tool. No explanation of the tool came with it, but the method to calculate results and their interpretations are provided. The handouts that were provided were all provided in plain black and white. While black and white handouts serve their purpose, handouts printed on colorful paper tend to encourage students to utilize them more frequently (Bradshaw & Lowenstein, 2007). Class Session: Laboratory Many of the course materials that were utilized for the lecture portion of the class also apply to the laboratory portion as one would expect. Additionally, as mentioned previously, the students were given the check-off lists for the procedures to be learned, which will guide them in their learning. The check-off lists do utilize colored paper, which enhance students’ utilization of them (Bradshaw & Lowenstein, 2007). The check-off lists are very detailed and guide the student through each step of the procedure being performed. The eye assessment check-off itself contains 15 different areas of focus. Some of these areas of focus contain sub-topics to be explored. Identification and Critique of Evaluation Materials Observed Class Session: Theory The FSU student was allowed to view the test for the section of the course that he was allowed to observe. The student was not allowed to obtain a copy for his own personal use, SM citing total avoidance of any opportunity for academic dishonesty. The examination consisted of

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50 multiple choice questions, each weighted at two points accounting for a total of 100 achievable points. The multiple choice question is composed of two parts. The first part is the stem which takes form of a question or incomplete phrase (Billings & Halstead, 2005). The second component is the made up of several choices, of which only one is the correct answer (Billings & Halstead, 2005). In some instances, all of the choices may be correct answers and the student is directed to choose the most correct or most appropriate answer (Billings & Halstead, 2005). When delicately prepared, the test utilizing multiple choice formats can demonstrate the use of critical thinking skills (Billings & Halstead, 2005). There are several advantages and disadvantages, both for the student and instructor when utilizing this evaluation method. In this case, it appeared that the questions were structured in a more remedial to advanced presentation. Questions built upon previous ones and increased in difficulty, requiring further use of critical thinking. At this particular institution, the student must reach at least 80% correct in order to pass the examination. An 80% is considered a grade of ‘C’ or average performance. Class Session: Laboratory For this portion, the FSU student was allowed to keep the evaluation tool since the students were given the tool as well. As stated previously, there are numerous areas of focus on each one of the check-off forms. The student must also achieve 80% accuracy in respect to completion of the return-demonstration in order to pass. The check-off forms are written very precisely with attention to detail, yet concise enough to fit on a single page. The FSU student was able to observe several students using the check-off forms for reference during their practice. Overall, the FSU student found the check-off forms very useful for the student and teacher to utilize for evaluation. They provide a uniform and consistent means in which to evaluate the students. Conclusion In summary, the student from FSU was allowed to observe a nursing class session taught by SM at a local college. The student viewed an adult assessment class focusing on the neurological assessment of the adult. The student was also able to view the associated laboratory

session. It is the student’s opinion after performing observation and critique of SM’s performance that she is an effective instructor. She is able to utilize many different approaches to instruction in order to meet the needs of her students. Her learning strategies were effective and entertaining at times. The course materials were effective, although could have been enhanced with the use of colored papers or other media. The evaluation methods observed were fair and consistent for all students. Overall, students were actively engaged in learning, both in the lecture and in the laboratory portion of the class.

Observation and Critique

References Billings, D., & Halstead, J. (2005). Teaching in nursing a guide for faculty. (2nd ed.). St. Louis, MO: Elsevier Saunders. Bradshaw, M., Lowenstein, A. (2007). Innovative teaching strategies in nursing and related health professions. (4th ed.). Sudbury, MA: Jones and Bartlett Publishers. Cuyamaca College. (2003). Visual learning [Fact sheet]. Retrieved from http://www.cuyamaca.edu/eops/dsps/resourcesvis.asp DeYoung, S. (2003). Teaching strategies for nurse educators. Upper Saddle River, NJ: Pearson Education, Inc. Parrott, T. E. (1994). Humor as a teaching strategy. Nurse Educator, 19(3), 36-38

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