Utilizing Blended Learning to Improve Efficiencies

Utilizing Blended Learning to Improve Efficiencies

Utilizing Blended Learning to Improve EfficienciesDebra A. Allan Danforth, MS, ARNP, FAANPDebra A. Allan Danforth, MS, ARNP, FAANP

Director of the Charlotte E. Maguire, M.D. and Director of the Charlotte E. Maguire, M.D. and Tallahassee Memorial HealthCare Tallahassee Memorial HealthCare

Clinical Skills and Simulation CenterClinical Skills and Simulation CenterAssociate Professor Associate Professor

Florida State University, College of MedicineFlorida State University, College of MedicineVirginia Henderson and Billye Brown FellowVirginia Henderson and Billye Brown Fellow

Debra A. Allan Danforth, MS, ARNP, FAANPDebra A. Allan Danforth, MS, ARNP, FAANPDirector of the Charlotte E. Maguire, M.D. and Director of the Charlotte E. Maguire, M.D. and

Tallahassee Memorial HealthCare Tallahassee Memorial HealthCare Clinical Skills and Simulation CenterClinical Skills and Simulation Center

Associate Professor Associate Professor

Florida State University, College of MedicineFlorida State University, College of MedicineVirginia Henderson and Billye Brown FellowVirginia Henderson and Billye Brown Fellow

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Description: 

Implementing blended learning can reduce costs, enable training of more people in less time and contribute to standardizing the education delivered across teams and departments. By utilizing combinations of various education methods such as self directed cognitive learning with  psychomotor hands on simulation, blended learning can work together to create high level efficiencies in education delivery.

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Learning Objectives:

1. Determine the goals of continuing education in health care2. Identify different learning styles and how different forms of e-learning and simulation can address each.3. Discuss simulation design based on some best practices in simulation education.4. Discuss how blending eLearning and simulation can improve efficiency and effectiveness resuscitation training programs.

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Nursing Objectives:

1. Describe different learning styles and how different forms of e-learning and simulation can accommodate each of them

2. Discuss simulation design based on some best practices in simulation education.

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Faculty Disclosure

I have a partial faculty conflict – Laerdal paid for travel to conference

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What is Blended Learning?

There no consensus on a single agreed-upon definition for blended learning. The terms “blended” “hybrid” and “mixed–mode” are used interchangeably in current research literature

A blended learning approach combines the best of face to face classroom methods with computer-mediated activities or simulations to form an integrated instructional approach leading to flexibility

By the year 2013, 7 in 10 school will have 40% of their courses with blended learning

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What is Blended Learning?

According to research shared at the ALN Conference Workshop on Blending Learning & Higher Education November 17, 2005, there is evidence that a blended instructional approach can result in learning outcome gains and increased enrollment retention

(http://www.uic.edu/depts/oee/blended/workshop/bibliography.pdf)– Cameron, B. (2003). The effectiveness of simulation in a hybrid and online

networking course. TechTrends, 47(5), 18-21. This research compared students’ performance on simulation-based courses and static graphic representational teaching of the same courses

content in an online learning environment. Results indicate that interactive learning tools, such as simulation, have the potential to increase student motivation and learning in an online environment.

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Standardized Patient

According to the Association of Standardized Patient Educators (ASPE) a standardized patient is a person trained to portray a patient scenario, or an actual patient using their own history and physical exam findings, for the instruction, assessment, or practice of communication and/or examination skills of a health care provider.

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Review of Literature: Standardized Patients (SPs)

Nursing education has historically been challenged with the problem of how to objectively evaluate clinical performance. – The National Organization of Nurse Practitioner Faculties

(NONPF) has developed guidelines for evaluation of nurse practitioner’s in interpersonal, communication, history-taking, physical examination and clinical decision making skills.

Utilizing standardized patients (SPs) in education has been shown to be a powerful teaching and evaluation tool in medical education and is currently being adopted by undergraduate and graduate nursing programs.

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Review of Literature: Standardized Patients (SPs)

Utilizing SPs in education allows faculty to develop patient-centered scenarios designed to meet specific curricular objectives.

SP interactions require students to apply classroom knowledge and clinical skills to real life situations. SPs in education allow control of the complexity of the clinical problem while providing students with patient experience in the health and medical sciences in a safe and supportive environment

Literature reports that faculty and nursing students find SP encounters to be realistic, challenging, and a worthwhile experience.

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Simulators vs. Standardized Patients

Simulators Standardized Patients

Communication Conversing is difficult

Conversing is easy

Pathology Programmed May be difficult to portray (murmurs)

Consistency of findings

Standardized Variable

Procedures “Unlimited” Limited

Availability “Unlimited” Scheduled

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e-Learning

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How to use Products

Laerdal provides eLearning courses for such products as:– VitalSim – SimMan 3G – SimNewB

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Healthcare Providers Course (BLS)

eLearning courses are delivered in one, two or three parts.

HeartCode BLS– Part 1. Upon successful completion of the online portion, including the written exam, students receive a Part 1 certificate of completion, which must be presented for parts 2 and 3.–Part 2*, a hands-on skills practice session with an AHA BLS Instructor or using a voice-assisted manikin (VAM) system–Part 3*, a skills test with an AHA BLS Instructor or using a VAM system–*Parts 2 and 3 should be completed in one “skills practice and testing” session.

http://www.youtube.com/watch?v=SYc8NKVlKn8&feature=player_embedded

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Hybrid

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Simulation Case

InterprofessionalSP (voice of simulator or significant other)SP interviewed and then assess on

manikin

SP

SP

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Case Materials

Time Monitor Settings

SP or Manikin (Actions)

SP M

Student Actions

First 5

minutes Initial Settings:HR 88BP 132/80SpO2 94%Temp 99.9

Breath sounds crackles bilaterallyCough (SP hits button or coughs)Peripheral pulses strongWife will ask if student does not introduce

X

x

X

x

Should be interviewing simulator and assessing vitals and physical exam

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ScriptElicit functional ability in 3 areas: 1. ADLs (bathing, dressing, grooming, mobility noting any aides, continence, feeding); 2. IADLs (phone use, med use, shopping, cooking, cleaning, finances, transportation); 3AADLs (recreation,

church, school, work)

Before, how was your ability for personal care, did you have difficulty bathing? Dressing? Grooming? ADL’s (Activities of Daily Living) Everything was fine Before, how was your ability to do things around the house and nearby? Did you have difficulty driving? Cooking? Using your medications? IADL’s (Instrumental Activities of Daily Living) – no problems

Before, how were you doing with your work, were you having any problems there? Any problems with your recreation? AADL’s (Advanced Activities of Daily Living) – Recreation- I can tell I’m not a teenager anymore. I have to stretch and warm up

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Harvey Utilization

Undergraduate – Vital signs– Location of heart

sounds Nurse Practitioner or

Medical programs– UMedic Program– Student instructions

with case presented then listen to heart sounds

– Scenario with standardized patient and then listen to heart sounds for diagnosis

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Harvey Utilization

Hybrid Harvey_Sam Jones Video Clip.wmv

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Infant Simulation

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Utilizing Blended Learning With The Female Exam

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Material online

Students observe– Camatasia or Elluminate– Observe a video on clinical

breast exam Palpation Pressure Pattern Perimeter Position

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Self Practice in Center

Come to center to practice – On simulated breast

(superficial, medium and deep)

– On breast pad (simulating breast exam and receiving instant feedback)

– On pelvic (inserting speculum)

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Meeting the Patient for Interview

Students go to the center and start with a focused history with their patients.

Patients are dressed in street clothes.

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Practicing Breast Exam on Simulated Breast

Go to the next room and practice the techniques on simulated breast with lumps

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5 Ps of CBE or SBE

Practice the 5 Ps– Palpation– Pressure– Pattern– Perimeter– Position

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Annie practice with positioning

Practicing placing Annie in the different positions and walking thru teaching.

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The exam

When go back in room women are already in gowns and ready for breast and pelvic exam

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Results to interpret

Students will receive a picture of what they observed

If available will also give a picture of a slide to interpret

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Patient Teaching and Closure

Students will write script for patient

Students will find a patient teaching either from the internet or their PDA’s

Closure with patient.

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SP Feedback

Students go back in and SP gives feedback on procedure, technique and demeanor.

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Mama Natalie

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Implications for Healthcare Providers:

Allows students to do on their own time (adult learners)

Allows assessment of clinical competence

Allows assessment of curriculum effectiveness

Thank You!Thank You!

Questions????Questions????

Thank You!Thank You!

Questions????Questions????

debra.danforth@med.fsu.edudebra.danforth@med.fsu.edu(850) 645-7123(850) 645-7123

debra.danforth@med.fsu.edudebra.danforth@med.fsu.edu(850) 645-7123(850) 645-7123