NR 536 Week 7 Designing an Experiential Learning Activity

Experiential learning activity 

Part 1: Foundation for the learning activity

NR 536 Week 7 Designing an Experiential Learning Activity

Experiential learning is a critical learning methodology that can foster and integrate different aspects of nursing such as theoretical knowledge, practical considerations, challenges, ideas, communication, collaboration, ethics, code of conduct, and other aspects in one single activity (Jones & Guthrie, 2012). It stresses on “hands-on” learning capabilities, psychomotor skills, concept mapping, and interactive learning (Nunes et al., 2015). The purpose of this paper is to develop an experiential learning activity for young nurses with experience below two years in a clinical setting to increase their skills, knowledge, and practice quality. The developed experiential learning activity will include all the aspects of learning objectives and aimed at specific learners under specific settings and scenarios. 

NR 536 Week 7 Designing an Experiential Learning Activity

Description of experiential learning activity

The experiential learning activity will be conducted in a skill development lab, which replicates an ICU a full-sized human patient simulator (HPS) mannequin with a chronic condition. The experimental activity is designed for a mentoring program for new graduates. Different roles will be assigned to the new graduate nurses and nurses with experience below two years by creating groups of five nurses with each nurse having a different role and responsibilities. A mentor will be present to monitor the activity, record the information related to the conversation, decisions taken by nurses, patient outcome, ethics, and civility in the workplace simulation. 

The group will be given a situation including a description of their characteristics such as their attitude, knowledge level, skills, competency, role, and overall storyline. The mentor can only intervene after the entire session or only when the conversation and process of the activity are deviating from the given objectives and storyline. After the completion of the enactment of the scenario, the group will be asked to evaluate each other’s perception, attitude, and conduct to question each other to analyze different challenges they faced during the process of patient care and interprofessional communication along with possible solutions (Victor et al., 2015). The non-participating students will follow the guided observation where students will be instructed to look and observe so that they can participate in the discussion and reflection process of the experiment. In this process, the mentor can ask questions and suggest alternative solutions. As a result, the process follows Kolb’s experiential learning to achieve the learning objectives by including abstract conceptualization, active experimentation, concrete experience, and reflection. 

NR 536 Week 7 Designing an Experiential Learning Activity

Learning objectives

The experimental activity includes three core objectives. Each objective is integrated into the activity by creating situations, characters, and practice processes. The first objective is to increase interprofessional communication and collaboration skills by demonstrating active learning. The second objective is ethics-based decision-making. The third objective is to educate the students about workplace civility and factors that lead to better civility and incivility due to poor communication and decision-making. As the learning activity includes simulation and HPS mannequin, it is in accordance with the learning competencies of new graduate nurses and benefits them in increasing their skills. 

Benefits of active learning

The identified learning activity fosters active learning at four different levels. The first level is the debriefing level or pre-learning level where nurses understand and replicate the characteristics of roles assigned to them. This allows nurses to actively learn the scenario, roles, and possible communication methods they can opt for. The second level of active learning is when participants perform the treatment on the HPS mannequin and observers look for different aspects of the process including the position of patient, tools, procedure, and other aspects. They not only practice but also learn by performing this level of activity. The third level of active learning takes place when they communicate with other nurses to establish collaboration and make decisions. The fourth level of active learning takes place in the discussion phase where students question and discuss the challenges, ethics, decision-making, possible solutions, and workplace civility. All of this can be possible only when the learning activity is clearly presented and executed. 

NR 536 Week 7 Designing an Experiential Learning Activity

Part 2: Presentation of the learning activity

Description of the setting

The experiential learning activity will be conducted in a skill development lab, which replicates an ICU in an acute health care setting with two rooms on either side of the room and a hallway. The skill lab includes a ventilator with a patient monitoring system, a full-sized human patient simulator (HPS) mannequin with the chronic condition of congestive heart failure who is at the risk of developing ventilator acquired pneumonia. The skill lab will be divided into four units. The units will be ICU with a ventilator and HPS mannequin, two adjacent rooms separated by a compartment, and a hallway. All the non-participating students will be placed in a circular fashion around the learning activity set. One student will perform the treatment procedure on the mannequin and one more student assists the student in the treatment procedure. One student each will be placed in two adjacent rooms. Mentors will be present in the activity area and another student will be present in the crowd as a nurse leader. 

Identification of the characters and roles

The role of the nurse educator is active as he or she will act as instructor and observer. The nurse is the non-participating student and the nurse leader. She has the role of administering different activities, managing the resources, mediating conflicts, maintaining civility in the workplace, managing operations, and motivating nurses to practice professionally by fulfilling responsibilities, ethics, and code of conduct. The nurse leader has characteristics of a good leader including better decision-making capabilities, communication, problem-solving, and easy to work with. However, because of increased work, she is intolerant to errors and has low patience at times. The nurse (nurse 1) who is by the bed-side has the role of nurse anesthesiologist, head to toe physical examiner, and patient monitoring role. She is of Korean descent. This nurse has mellow characteristics as she is well-behaved, soft-spoken, and easy to work with. However, she has lower self-confidence and can be bossed around easily. Another nurse (nurse 2) by the bedside has the roles related to hygiene maintenance, rapid triage management, discharge planning, and the role of communicator between family and multi-disciplinary team. This nurse has the characteristics of gregariousness, high confidence, deferential, and understanding. 

NR 536 Week 7 Designing an Experiential Learning Activity

The nurses in adjacent rooms to ICU have the same role as the bedside nurse. However, the nurse in the left room (nurse 3) is highly ambitious and has characteristics of dogmatic, high confidence, talkative, bossy, and intimidating. Also, she has 18 months of extra experience compared to other nurses. The nurse in the right room (nurse 4) is non-confrontational, shy, and has laconic nature, but has high competency, skills, and competency. As all four of the nurses have different characteristics, their behavior and roles affect the outcome of a scenario. 

Outline of the scenario

Three patients are present in this setting with one patient in ICU, one patient each in adjacent rooms. The patient in ICU is a 65-year-old male with congestive heart failure. The patient in the left room is suffering from Alzheimer’s disease. The hospital has the policy of using bundle treatment for bed-ridden patients to reduce the chances of pressure ulcers and prevent infections. It was recommended by the nurse leader and healthcare team to follow the 30-degree ventilator angle rule and physiotherapy every three days. The family member of the patient in the left room complained to the nurse in the ICU that the patient has not received physiotherapy in four days. After examining, the nurse from ICU observed that the ventilator position in the left room is near 40 degrees. During her examination, nurse 3 entered the room and saw nurse 1 examining the patient. The conversation between these nurses led to conflict and nurse 3 was shouting at nurse 1. Nurse 2 and 4 entered the hallway and listened to the conversation. Nurse 2 decided to call the nurse leader as conflict led to verbal altercation and incivility. Nurse 4 heard everything but did not intervene even though she knew nurse 3 was exhibiting incivility and was arguing instead of acknowledging her mistake. After a few minutes, the nurse leader entered the room and tried to solve the issue and conflict by involving everyone who was involved in the scenario. 

NR 536 Week 7 Designing an Experiential Learning Activity

Interactions between the characters

Nurse 3: What are you doing here?

Nurse 1: the family member complained that the patient has not received physiotherapy for 4 days. I just wanted to check if there are any mobility issues. Also, the ventilator inclination angle is around 40-degrees. As she is an old woman, it will affect her back and may cause discomfort. As an anesthesiologist nurse, I recommend you to maintain her sedation timing as it might help the patient to recover quickly. This indicates interprofessional communication as the nurse is providing her expertise in the field. 

Nurse 3: angrily said I know what I need to do and I know the rules. I do not need a newbie to explain this to me. I do not know how you guys handle patients in China, but here in the USA, only an assigned nurse will attend the patent. This highlights incivility as the nurse attacked the culture of her peer and was prejudiced. If anything goes wrong, I have to face the consequences as she is my patient and my responsibility. This highlights the issue of ethics. 

Nurse 1: I am not from China and I was born in the USA. I am a US citizen. By the way, I was just trying to help you and the patient as you were absent and it is my obligation to promote the health of patients in this health care even though she is not my patient. However, I sincerely apologize for interfering in your work, and in the future, I will not be involved in such issues. This highlights the ethical dilemma as the nurse is considering not helping the patient when the patient needs it because of the rude behavior of nurse 3.

Nurse 4 observed the conversation but did not try to intervene whereas nurse 2 decided to call the nurse leader as the conversation was escalating.

The nurse leader and the other two nurses enter the room to solve the conflict. 

NR 536 Week 7 Designing an Experiential Learning Activity

Debriefing

Role of debriefing and debriefing process

The role of debriefing is multidimensional in experiential learning activity as it allows the nurse educators to communicate different aspects of the activity to the participants (Victor et al., 2015). The first role is it allows the nurse educator to explain the purpose and objectives of the experiment to the participants. The second role is it helps the participants to understand the process and question about the process and its aspects. This includes the role of each participant, characteristics, and behavior of each participant, their responsibilities, the importance of learning activity, and allows the participants to prepare themselves for the experiment (Romaniuk et al., 2020). Further, the debriefing process also helps the participants to understand the outline of the learning experiment. Also, it identifies the role of non-participating nurses in the process and the importance of their participation in different stages (Young & Dufrene, 2020). 

The debriefing process will be based on simulation and sketch board in phase one. Here, roles and responsibilities along with the objectives and purpose of the learning objective will be given to participants in a written format. The scenario and stages will be explained by using simulation and sketches. All of this process will be carried out in the classroom (Romaniuk et al., 2020). Later, a second briefing will be conducted in the actual setting as it helps the students to understand the setting and environment. Finally, a basic rehearsal will be conducted just to show the different positioning of participants and their position with time and scenario outline (Young & Dufrene, 2020). 

NR 536 Week 7 Designing an Experiential Learning Activity

Socratic questions

The three Socratic questions are: 1) is open-ended communication beneficial than scripted dialogues in experimental learning? 2) is it enough to conduct just one experiment with one group of participants? 3) what are the possible barriers that may lead to poor execution of the experiment?

Conclusion

Experiential learning activities play a major role in increasing skills and competencies in nursing students and nurse staff. The process of developing experiential learning includes understanding its importance, identifying objectives and learner types, identifying and adopting experiential learning activity type, describing activity plan, presenting activity plan and outline, debriefing the participants about the experiment and the role of participants. The paper used Kolb’s experiential learning model along with HPS mannequins and skill development lab to create a scenario that aimed to fulfill the objectives of interprofessional collaboration, ethics, and civility. 

NR 536 Week 7 Designing an Experiential Learning Activity

References

Jones, B., & Guthrie, K. (2012). Teaching and learning: Using experiential learning and reflection for leadership education. New Directions For Student Services. https://doi.org/10.1002/ss.20031

Nunes, S., Prado, M., Kempfer, S., & Martini, J. (2015). Experiential learning in nursing consultation education via clinical simulation with actors: Action research. Nurse Education Today35(2). https://doi.org/10.1016/j.nedt.2014.12.016

Romaniuk, D., Paula, M., & Liu, L. (2020). Comparison of debriefing methods after a virtual simulation: an experiment. Clinical Simulation In Nursing19. https://doi.org/10.1016/j.ecns.2018.03.002

Victor, C., Turk, M., & Adamson, K. (2015). Effects of an experiential learning simulation design on clinical nursing judgment development. Nurse Educator40(05). https://doi.org/10.1097/NNE.0000000000000159

Young, A., & Dufrene, C. (2020). Successful debriefing—Best methods to achieve positive learning outcomes: A literature review. Nurse Education Today34(03). https://doi.org/10.1016/j.nedt.2013.06.026

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