Online Problem-Based Learning Module for Advanced Nursing Students Case Study
Kevin Smith, a professor of nursing, developed online, case-based, interactive learning modules using a "problem-based" learning approach for the class, Primary Care for Advanced Practice Nursing Students. Students used the modules to learn how to perform a routine health maintenance examination and incorporate into it health promotion measures. He also used humor throughout the modules to enhance the learning environment.
Instructional Goals
Smith wanted to
- enhance learners' individual problem-solving and critical-thinking skills related to heath maintenance and health promotion;
- engage the very self-motivated students in a more active process;
- improve access to graduate nursing education, especially for nurse practitioner students who could then practice in rural areas where there are shortages of health-care professionals, and
- incorporate humor and games into learning activities.
Technology Strategies
Instructional technology was already being used successfully in the School of Nursing. Distance education (23 web based offerings) Collaborative Rural Nurse Practitioner Project RWJ Partnerships for Training Project TEL grant Digital Media Center fellowship
Smith and ? developed a custom chat tool using Flash Communication Server technology and used it to present case studies and a game to students.
A typical case included the following steps and enabled students to access the previous and next step from each one:
- opening Scenario/Brainstorm differentials
- history of present illness
- past history, family history, social context
- physical examination
- diagnostics
- management
First, the instructor posted a typical scenario for nurses doing intake assessment, such as "a person has come in with an earache." This appeared in a static text area so students could review it throughout the process. The students brainstormed possible causes of the problem and discussed the merits of each suggestion using a chat tool. The instructor used the polling tool throughout the discussion to enable the class to either accept or reject each suggested cause, generating a short list of likely causes. After gaining experience with the process, students took turns leading their own sessions—posing their own scenarios (e.g., a patient experiencing trouble breathing), moderating the chat, creating polls as necessary, and building consensus.
In Session One, students
- CC/Brainstorm History Exam Labs Generate Learning issue List
In Session Two, students
- Review case Take turns presenting learning issues Finalize plan/teaching Rinse and repeat
Smith and ? also developed a Millionaire Game.
Learning Outcomes
When surveyed about their use of the tool, the students overwhelmingly responded that they learned more about the material and felt more connected to their classmates and the instructor, even though half had never participated in an online chat and two thirds had never participated in an educational online chat. This suggests that the combination of PBL and consensus building helped students learn as well as create positive first impressions of online educational activities.
| Activity/Answer | A great deal | Somewhat | A little bit | Not at all |
|---|---|---|---|---|
| The online PBL session helped me to learn more about the process of Problem-based Learning. | 56.7% | 33.3% | 10.0% | 0% |
| The online PBL session helped me to learn more about the clinical subject matter related to the case scenario. | 36.7% | 60.0% | 3.3% | 0% |
| The online PBL session helped me to feel more connected with my classmates (group) and instructor. | 50.0% | 30.0% | 16.7% | 3.3% |
| Based on the following [possible answers], how would you rate the overall value of this activity as a learning tool? | 43.3% | 46.7% | 10.0% | 0% |
| Question/Answer | Yes | No | ||
| Given the option, would you choose to use the online PBL discussion tool again as part of an online learning course? | 86.7% | 13.3% | ||
100% of respondents enjoyed and felt they learned from the Millionaire Game
One key to the success of this project is that Smith did not present students with an "either/or" dichotomy. Students generated a list of possible diagnoses, and reduced it by process of elimination. Some items were withdrawn by their originators if there was a lack of support. Others were originally met with skepticism, but gained favor on the strength of argument. This is the process recommended by Sarla Stensaas in "Technology and Classroom Authority" (see the Bibliography below).
Whether using a student response system or an online polling tool, consensus building activities compel students to consider their preconceptions carefully, argue persuasively, and engage in active listening—skills useful in almost any discipline.
Related Resources
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