NR 621 Intervention:Evaluation Plan

Introduction

NR 621 Intervention:Evaluation Plan

Incivility in nursing education has been perpetuated by clinical placement preceptors, academic staff, students, and patients, and has occurred in both the classroom and clinical placements. Incivility has physical and psychological consequences for victims, and it can lead to hazardous patient care. In the context of nursing education, little is known about effective interventions to prevent or reduce the practise of incivility. Nursing students may provide effective healthcare if the role-playing technique used to address incivility is successful and relevant to present students. The goal of this project was to perform a mixed-methods literature evaluation to establish role-playing tactics for dealing with incivility among nursing students, as well as their consequences.

Nurse incivility is an issue that has ramifications across the healthcare system. Incivility can lead to intimidation, which can cloud clinical judgement and jeopardize patient safety. Incivility has an impact on patient safety since it is a “contributing factor in 98,000 fatalities in acute care settings each year” 

The role play exercise should also not take place soon before or directly after a test, as the exam may induce tension in the students, reducing the efficacy of the activity (Burnes, 2020). The activity in this course was properly timed so that it would not clash with a test or other important occasion. The role play exercise should not take place just before or after a test, as the exam may cause students to get tense, decreasing the activity’s effectiveness (Burnes, 2020). This course’s activity was carefully scheduled to avoid conflicting with an exam or other significant event.

The role-playing possibilities in the systems analysis and design course are many. Client interviews, proposal presentations, and team meetings are all apparent instances. This study, on the other hand, is about a more modern, unique, and creative role-playing approach: utilizing analytical IT diagrams as scenarios or scripts for role-playing sessions. Furthermore, incivility has an influence on nursing turnover rates, which can cost a hospital up to 125 percent of a registered nurse’s (RN) yearly pay to replace each individual nurse who quits their position (Deborah, 2018). The Joint Commission and the American Nurses Association urge that such disruptive conduct be treated with zero tolerance, and they set targets to enhance awareness of incivility and address it within the nursing profession and medical institutions. The use of role-playing as a technique for educating undergraduate students about the topic of care prompted contemplation on the skills and talents required for caring for others and supported the students’ self-perception as nurses, seizing the essence of their future profession: care.

NR 621 Intervention:Evaluation Plan

The Long-Term Goal Of This Proposal

This proposal’s long-term goal is to manage incivility among nursing instructors.

Teaching utilizing the role-playing method will improve students’ capacity to provide better patient care and will assist teachers in dealing with uncivil situations when they arise. When the new role-playing teaching approach has been successfully integrated into nursing students’ education, this will be determined. In addition, the plan should aim to boost NCLEX graduation rates. Once the nursing faculty has effectively implemented the new teaching intervention, this will be evaluated.

The Short-Term Goal of The Proposal

The goal of this research is to improve mid-term exam results. The overall score/value of the test will be compared to a previous exam in the same field to evaluate if students’ learning outcomes improved after trials and implementation of new teaching techniques (role playing intervention) in nursing students.

Practicum Site and Stakeholders

After a competitive process based on submissions that detailed their teaching techniques, participation in new activities, and specific requirements or objectives for developing teaching strategies, the use of role-playing strategy in teaching was evaluated and applied in 5 faculties chosen from a pool of 35 candidates. The project manager allowed the Dean and Department Chairs to express their support for the participating universities, which were picked by a committee of administrators, senior professors, and Advanced Learning Center workers.

We assessed a range of characteristics that contribute to successful student learning during the learning design process and lesson preparation, such as needing/wanting, doing, digesting, and getting feedback. It was observed that rather than delivering pure lectures that place students in a passive state, it is necessary to provide engaging activities. Role play as an active teaching method may contain these advantageous features of enjoying learning and absorbing knowledge if it is properly planned and implemented.

Moreover, the theoretical-methodological framework of this study is based on assumptions of the critical pedagogy and emancipatory education, as well as on national and international studies about role-playing as a teaching strategy in nursing.

Project Implementation

The faculty need a variety of factors in order to incorporate role playing teaching strategy in the classroom. In the implementation phase, the above-mentioned demands of each plan were considered. The mentoring activities that were carried out during implementation are listed below.

Role-Playing In Learning Helping Skills

I looked into whether the course “First Aid in Case of Suicide,” which included role-playing as a major teaching approach, was appropriate for medical students. Role-playing in mental health education helps students to become active learners who are at the center of their education. Because textbook explanations of what it feels like to be upset or in conflict are insufficient. Students took on the roles of both the customer and the interviewer as part of a plan. In focus groups of 2–12 students, 27 (62%) of the 35 students who took part in the course were interviewed. Students in training were often instructed to identify with the position of the professional at the time, and role-playing the customer was uncommon. Students were given roles that required them to make a subjective selection of criteria for a certain diagnosis, as well as explain and perform the selection in role-play. The technique proved effective in lowering students’ anxiety, improving their understanding of ideas and abilities, and increasing their identification with the patient. 

During simulated medical interviews, the students role-played patients and doctors, (Martin, and Kahn,1995). They said that taking this method helped students have a better understanding of patients’ behavior and usual reactions from clinicians. Students said that practicing certain situations and receiving immediate feedback on their abilities was beneficial. When they practiced aiding a person in danger of suicide and role-played the person in danger of suicide, they learned a lot. The students found it beneficial to put themselves in the shoes of the patient and therefore get familiar with the emotional reactions that happened in the role-playing setting.

NR 621 Intervention:Evaluation Plan

Guided Role-Play In Teaching Therapeutic Skills

For teaching the interview of a mental patient. Students were instructed to take on the roles of both the interviewer and the patient. Students in training were often instructed to identify with the position of the professional at the time, and role-playing the customer was uncommon. Students were given roles that required them to make a subjective selection of criteria for a certain diagnosis, as well as explain and perform the selection in role-play. The technique proved effective in reducing students’ anxiety, improving their understanding of ideas and abilities, and enhancing their identification with the client.

They also grew more aware of their own responses and weaknesses. This approach is also linked to Carl Rogers’ humanistic and person-centered worldview. (Carl, 1994) Rogers believed in the ability of the person to heal and learn. Role-playing improves and supports personal and professional development by allowing students to experience what it’s like to be in someone else’s shoes and, as a result, build empathy and introspection. The learner has a stronger capacity for treating people with the respect and understanding necessary in mental health treatment as a result of this type of learning.

A Role-Play-Based Approach To Teach Clinical Communication

We assessed a new role-play-based method to teaching clinical knowledge and communication in mental health for medical students using an assessment questionnaire developed by King, Hill, and Gleason (2015). The role-play-based learning (RBL) technique consisted of a series of training modules, each of which comprised a patient’s story and facilitator instructions. A week before the class, the students were given scenarios for the patient, relative, or matching health professional. The pupils took on the roles of both the doctor and the patient. A group discussion and feedback session followed the role-play. The questionnaire was distributed to a total of 25 medical students. The questionnaire asked about the number of sessions attended and then asked the students to respond to a selection of statements using a five-point Likert scale (1 = strongly disagree; 5 = strongly agree). 

The students were enthusiastic with the sessions’ features, describing them as interesting, educational, and timely. Their role-playing sessions were described as hard yet useful. They said that by taking on the role of the patient, they gained a better grasp of the patient’s perspective.

Role-Play Activities Concerning Auditory Hallucinations

Through simulation and role-play exercises, I explored bachelor nursing students’ personal experiences of hearing voices. Data was obtained using an interpretative phenomenological technique, with 22 students in their first mental health didactic course responding to written surveys. A hearing-voices simulation programmed and role-play activities were utilized as the intervention. It included 1) an introduction to the hearing voices package, 2) participation in the simulation, 3) role-playing, 4) a debriefing session, and 5) completed questionnaires.

The students donned headphones and experienced a simulation of hearing voices while completing various activities during the simulation. During the role-play, a student who was hearing voices was sent to the emergency room for assessment. The students worked in groups of two, with one acting as a nurse and the other as a person suffering from auditory hallucinations. Students might ask questions and receive answers during the debriefing following the role-play.

Finally, questionnaires were used to obtain data. The surveys included four open-ended questions about the nurses’ perceptions of communicating with people who have mental illnesses before the simulation and role-play, their perceptions after the simulation and role-play, how they would communicate with people who have auditory hallucinations, and their experiences with the simulation and role-play.

NR 621 Intervention:Evaluation Plan

The students had expressed concern and apprehension about connecting with those who could hear voices. They felt safer and developed new understandings and attitudes towards engaging with patients who hear voices after the simulation and role-plays. Students described how being told that they were hearing voices affected the way they communicated. They also discussed how the simulation and role-play affected their perceptions and how they developed greater empathy and respect for people with mental illnesses as a consequence of the experience.

The Use of Role-Play To Teach Psychiatric Interviews

I developed role-playing approaches for conducting psychiatric interviews, in which medical students took on several positions, including that of the patient. Following that, I performed a quantitative research in which I created and distributed a survey to students who had engaged in role-playing activities. Third-year medical students on an inpatient psychiatric rotation met with the ward’s physician once a week for monitoring and teaching. They employed role-playing to learn the patient interview during the initial meetings. The physician established the roles and began by playing the patient.

After ten minutes, they switched positions, with one of the students taking on the role of the patient. They paused the interview and discussed the session at the conclusion of the meeting. A survey was created and given to 28 students, with 21 (68 percent) responding. 71 percent said the experience made them more aware of patients’ feelings, and 90 percent said the role-play made them more aware of their own feelings; 84 percent said the experience could be used in other rotations; 94 percent used the skills learned during their rotations, and 74 percent said they could use the skills in other rotations; and 84 percent said they could use the skills in other rotations. The interviewer position was more difficult to depict than the patient one, but the exercise was an excellent approach for teaching interviews, according to the students.

The professors indicate that role-playing was found to be beneficial. The students discovered that they had a greater grasp of their own and their patients’ emotions. The findings also suggested that the abilities could be useful in other medical school rotations. Students were able to distinguish distinct emotional states for various roles, and role-playing forced them to consider the interviewer’s frustrations and the patient’s concerns. It helped students become more compassionate and successful in enabling the doctor–patient interaction by overcoming their fears about interviews.

NR 621 Intervention:Evaluation Plan

The goals of this role-playing technique were slightly different. Three of the role play techniques looked at role-playing as a teaching method and technique, while the fourth looked into students’ experiences with role-playing as a learning activity. Despite the fact that the goals of this intervention method were slightly different, the outcomes appeared to be similar. All of the research found that role-playing helped students build their attitudes and therapeutic knowledge, and that it improved their learning. Role-playing was found to make students better practitioners.

Quasi-Experiment

This quasi-experiment was done with the goal of comparing the effects of lecture and role-playing education on nursing students’ learning and determining the link between students’ characteristics and theoretical test and role-playing checklist scores. I presented the entire programmed to students at the start of class and persuaded them of the benefits of role acting and its relevance in the transmission of educational experiments. Students were first introduced to certain concepts and principles of patient training through a lecture with questions and answers (during the first four lessons).

After that, in addition to receiving the essential instruction on how to implement, students were requested to form team work groups freely and under the supervision of the teacher, pick actual patients in the hospital, and demonstrate and critique the training process using the role-playing technique. In this course, the lecture technique was used for four sessions of instruction. The first session covered the objectives of the lesson learning process and patient training, as well as teaching techniques, instructor tasks and student responsibilities, definitions of teaching and learning, and learning facilitators and obstacles. Explained some information with questions and answers on how to review the patient’s training needs and write learning objectives in three domains: cognitive, psychomotor, and affective in the second session.

NR 621 Intervention:Evaluation Plan

 The third session focused on various patient teaching approaches, with a focus on role-playing. The steps of role playing and scenario writhing were demonstrated in this workshop. In the second and third sessions, students were required to answer certain questions regarding the topics provided based on an assumed example patient (to create training requirements and training goals for a specific patient). In the fourth session, we discussed several approaches for evaluating patient training programmers. Students in role playing groups studied the history of the patient by running a workshop and determined goals, proper method of training, and evaluation for the needs of patient training in their groups in another session that was conducted to resolve possible ambiguities and clarify different aspects of the course.

After collecting their history and identifying their training requirements, students chose genuine patients in small groups under the supervision of teachers and established training goals and priorities for everyone; then essential trainings were implemented and trainings were assessed. Following completion of the aforementioned stages, students created a training scenario, which they then presented in front of other students and teachers in the classroom following training and thorough preparation. Following each presentation, one of the group members provided feedback on the group’s performance, and other students were given the opportunity to ask questions. In all of the processes, the teacher provided full assistance and direction to the pupils. Role acting as a cooperative technique enhances student learning more than lecture method, according to the findings of this activity. Students’ scores in the role-playing technique were considerably higher than those in the lecture style, according to the activity’s findings.

NR 621 Intervention:Evaluation Plan

Project Evaluation

Through observations, faculty who are qualified to teach the course evaluated the mentorship and implementation approach. I conducted interviews with people who took part in the programmed using a course assessment item. Factors that contributed to the project’s success were determined using the evaluation technique.

Evaluation By Observation And Evaluation Question

Learners were given an observation and a question at the end of the course. The faculty’s ability to develop and build online learning modules, organize role playing activities, organize course content, and initiate and monitor student discussion activities was rated using a university assessment form. The students’ viewpoints were assessed using the end-of-course questionnaire to see if they had changed as a result of the simulation and role-play. After getting guidance from a teacher, students reflected about their misbehavior and, in most cases, sought a solution to the problem. After giving it some thought, they decided to change or amend their behavior. This caused them to alter their minds about that particular behavior, removing any bias, misunderstanding, or hatred (Mousselines, et al., 2020). Appropriate behavior management resulted in a reasonable relationship, in which unruly pupils became close to their instructors, and distrust was transformed into reciprocal trust. Most students say that mutual understanding and sympathy come after rapport and empathy, and that they cease being disruptive in order to win their instructors’ favor.

Evaluation By Interview And Self-Evaluation

Personal interviews with each of the faculty members were part of another evaluation of the project, in addition to my review. According to guided democracy, one of the benefits of controlling incivility was students’ educational participation. Students were directed toward good study preparation by teachers’ suitable incivility management; they also got the option to prepare for research and extracurricular activities. As a result, preparing for educational development and empowerment gave them even more energy and enthusiasm to avoid incivility (Williamson & Muckle, 2018). As a consequence of this evaluation, learners’ learning experiences were enhanced, mentor skills were strengthened, and access to resources was facilitated, among other things.

Change Model: Force Field Model And The Unfreezing-Change-Refreezing

            Model In 1951, Kurt Lewin came up with the idea. He devised a three-stage transformation model that considers and investigates the dynamics and variables that affect a scenario. Implementers, according to the theory, should reject past knowledge and replace it with fresh new ideas. If one can identify factors that need to be molded for change, it is essential to understand what should be decreased or strengthened to bring about change (Burnes, 2020). Change happens as a result of how some concepts behave (Burnes, 2020). Because behavior adds to a force that is either limiting or driving, this is the case. The model’s three stages are unfreezing, movement, and refreezing. Unfreezing is the initial stage, which includes creating a strategy to assist people in breaking old behaviors and overcoming resistance factors (Deborah, 2018). This level will be used by educators and students who will reject traditional teaching techniques in favor of innovative role-playing-based interventions. Stakeholders can do this by improving driving forces and reducing restraining pressures that impede progress (Radicchio, 2020). The next stage is to move or alter. As a result, feelings, attitudes, and behaviors all change. This will be accomplished if hesitant learners and other educators are convinced to abandon the status quo because it is ineffective, collaborate with others in working, and join forces with important leaders who support the change (Deborah, 2018).  

NR 621 Intervention:Evaluation Plan

Self-Reflection

Reflection and interactive role-playing intervention, according to educators and students’ experiences, are techniques that may be used to address incivility. Educators can look back on their teaching techniques as well as prior encounters with incivility to figure out what is causing such conduct. They may assess their performance and enhance their behavior and morale in order to feel more confident in managing challenging behaviors.

Teaching-Learning Strategy

This strategy’s subcategories include improving students’ involvement with education, fairness in evaluation, suitable apprenticeship techniques, motivation, and attractiveness. Because many instances of incivility are based in teaching techniques and learning skills, adopting the above-mentioned correct teaching approaches and giving attraction and incentive can assist educators and students avoid incivility. Engaging all students in the teaching process, as well as utilizing various apprenticeship methods for different students, particularly those who are prone to incivility, can assist in the management of such behaviors. Fairness in evaluation of students’ performance can prompt a good feeling in them since they know that those who express more endeavor and respecting the rules are treated differently comparing to those who does not regard such matters; and this can eventually help reducing incivility.

References

Burnes, B. (2020). The Origins of Lewin’s Three-Step Model of Change. The Journal of Applied

Behavioral Science, 56(1), 32-59.

Deborah, O. K. (2018). Lewin’s Theory of Change: Applicability of its Principles in a

Contemporary Organization. Journal of Strategic Management, 2(5), 1-12.

Mousavinasab, E., Kalhori, S. R. N., Sanaee, N. Z., Rakhshan, M., & Saeedi, M. G. (2020).

Nursing process education: A review of methods and characteristics. Nurse Education in

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Practice, 102886.

Nes, A. A., Fossum, M., Steindal, S. A., Solberg, M. T., Strandell-Line, C., Zlamal, J., &

Gjevjon, E. L. (2020). Research protocol: Technology-supported guidance to increase

flexibility, quality, and efficiency in the clinical practicum of nursing

education. International Journal of Educational Research, 103, 101628.

Radicchi, V. (2020). Technology and Nursing Education in Europe: A Literature Review.

Williamson, K. M., & Muckle, J. (2018). Students’ perception of technology use in nursing

education. CIN: Computers, Informatics, Nursing, 36(2), 70-76.

Martin, P., & Kahn, J.(1995) Medical students as role playing patients. Acad Psychiatry.;19(2):101–107. doi:10.1007/BF03341538

Rogers, C.(1994) Freedom to Learn. New York (NY): MacMillan College Inc.

King, J., Hill, K., & Gleason, A. (2015), All the world’s stage: evaluating psychiatry roleplay based learning for medical students. Australas Psychiatry;23(1):76–79.

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