With technological innovations making an impact across the healthcare industry, changes are taking place within education as well. New and innovative teaching strategies are constantly emerging and moving through the space.

However, it’s important to note that the core principles of nurse training remain unchanged: patient-centred care, evidence-based practice, communication and interdisciplinary teamwork continue to be key training requirements in the nursing profession.

As change leaders, nurse educators must be aware of these emerging methods. This article outlines four key strategies that are making their way into nursing education:

In-situ simulation;
Interprofessional education and training;
E-journal clubs; and
Interleaving and retrieval.

In-Situ Simulation

“Practice like you play and you will play like you practice” (Brown, Roediger & McDaniel, 2014).

Simulation has been identified as a method of training that has proven safety and quality benefits, particularly in the identification of latent safety threats with practicing procedural training exercises (Patterson et al., 2012).

However, as the workplace becomes busier, freeing up staff to attend simulation training in a dedicated simulation centre or training facility can be difficult.

So, why not try performing the simulation in situ?

Training in the familiar workplace environment using your own equipment, whether low or high fidelity, will likely feel more like a real experience. It can deliver structured, dynamic, goal-directed activities and incorporate work-practice relevancy, so the learning experience shouldn’t be underestimated (Billet, 2002).

Nurse educators must remember to properly plan the simulation, ensuring that time for feedback is built in.

The simulation debrief and feedback allows participants to make sense of the process, align it with the key learning objectives and adjust for future performance and actions (Rudolph et al., 2007).

Interprofessional Education and Training

Healthcare provision is based around collaborative teamwork. When things go wrong, aspects such as communication and disjointed care are cited as important safety lessons.

The World Health Organisation (2014) has recognised the need for a “collaborative practice-ready” workforce in order to improve health outcomes.

And while we work in collaborative teams to deliver patient-centred care, we often train within our own discreet professional domains.

Procedural training, patient deterioration and advanced life support provide valuable opportunities to train together and promote understanding and collaborative practice. This can also aid in the development of effective communication, relationship building and the ability to challenge hierarchies (Theilen et al., 2017).

The opportunity to develop and set problem-based team learning exercises is essential to de-silo and promote interprofessional practice within healthcare.

E-Journal Club

Having regular educational opportunities where learners can review and discuss the latest evidence is essential for the translation of evidence into practice.

However, education is never that simple. It is difficult to have regular attendance using a traditional journal club approach (Mehta & Flickinger, 2014).

The need to deliver education in a synchronous and asynchronous manner can therefore be met using an e-journal club approach (Chan et al., 2015).

Incorporating social media tools as a platform to share and discuss articles is a great way to enable more widespread participation. Including a discussion thread for participants to engage, question, discuss and share resources can work to create a learning community within an organisation or workforce.

Nurse educators should act as facilitators in this space: judging when discussion can be developed further, or when it should be taken to new areas.

However, educators and workplaces must ensure that they can maintain and enforce nursing codes of conduct. Having an e-journal club code of conduct with information regarding confidentiality, engagement and respect is advisable.

Learning: Interleaving and Retrieval

When teaching, it’s imperative that nurse educators take steps to ensure their learners can maximise the retention of new skills and knowledge.

As the capacity of our working memory (and by extension the amount of information we can pass into our long-term memory) is limited, there are a few tactics we can use to try to combat this.

Interleaving is the practice of studying concepts or topics that are closely related to the core subject, at different levels of knowledge (Brown, Roediger & McDaniel, 2014). By slightly varying the learning, there is more repetition and recall required in the learning process which thereby strengthens memory.

The retrieval process can be further enhanced by the regular use of testing and prompts, such as cue cards.

Chunking is another technique used to maximise retention.

It is a problem-solving solution whereby smaller, separate pieces of information are combined into more meaningful, and therefore memorable, chunks. This allows us to add short term information and create links to transfer this into our long-term memory.

Educators should also encourage learners to find hooks that they can relate new information to. For nurses, relating the learning content to a lived clinical experience can provide this hook.

Conclusion

As change leaders within a healthcare organisation, nurse educators should assess and evaluate the impact of introducing innovative teaching strategies against how they will shape the changing role of nursing.

References

Billett, S. (2002). Critiquing workplace learning discourses: participation and continuity at work. Studies in the Education of Adults, 34(1), 56-67.
Brown, P. C., Roediger, H. L., & McDaniel, M. A. (2014). Make it stick. Harvard University Press.
Chan, T. M., Thoma, B., Radecki, R., Topf, J., Woo, H. H., Kao, L. S., … & Lin, M. (2015). Ten steps for setting up an online journal club. Journal of Continuing Education in the Health Professions, 35(2), 148-154.
Gobet, F., & Clarkson, G. (2004). Chunks in expert memory: Evidence for the magical number four… or is it two? Memory, 12(6), 732-747.
Mehta, N., & Flickinger, T. (2014). The times they are a-changin’: academia, social media and the JGIM Twitter Journal Club. Journal of General Internal Medicine, 29(10), 1317-1318.
Oakley, B. (2014) A Mind for Numbers: How to Excel in Math and Science (Even if You Flunked Algebra). Penguin, July, 2014
Rudolph, J. W., Simon, R., Rivard, P., Dufresne, R. L., & Raemer, D. B. (2007). Debriefing with good judgment: combining rigorous feedback with genuine inquiry. Anesthesiology Clinics, 25(2), 361-376.
Patterson, M. D., Geis, G. L., Falcone, R. A., LeMaster, T., & Wears, R. L. (2012). In situ simulation: detection of safety threats and teamwork training in a high risk emergency department. BMJ Qual Saf, bmjqs-2012.
Theilen, U., Fraser, L., Jones, P., Leonard, P., & Simpson, D. (2017). Regular in-situ simulation training of paediatric Medical Emergency Team leads to sustained improvements in hospital response to deteriorating patients, improved outcomes in intensive care and financial savings. Resuscitation, 115, 61-67.
World Health Organization. (2014). Framework for Action on Interprofessional Education and Collaborative Practice. Geneva, WHO, 2010.

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