Conclusion and Final Thoughts

       Now that everyone’s mind is overloaded with material, (smile), I feel I have discussed the objective of the teaching/learning plan which was to describe and correctively perform a cognitive/neurological assessment. The rationale for performing a correct cognitive/neurological assessment is evident by assessment consistency which is the key to identifying changes in a patient’s status and identifying changes early which leads to faster treatment. Faster treatment leads to better outcomes for the patients (Rehabilitation Standard of Care, 2011). This teaching plan focused on staff education and its’ objectives using Bloom’s taxonomy. 

     I think the information was given in an orderly fashion specific enough that anyone reading the introduction and objectives would know exactly what material would be presented. Various teaching media/materials were discussed as well as developed discussion questions that can be used to evaluate the learner’s achievement of the objectives. 

     I would like to share my own insights and reflection of what I gained from this lesson plan since I followed the technique of the learning framework. The learning framework and my own teaching philosophy created a foundation to begin the project. I believe communication and the interaction with one another in this type of setting (staff education) is highly important because sometimes information is not clearly communicated to all. I feel this is a reason various types of media/materials are used, so that information can be presented in other forms.

     Funny thing was, tension was building when I realized how much information was too much information or lack thereof, throughout the teaching/learning plan. . .LOL! I also felt that this topic required appendices (A-E), to provide enough material to review prior to the staff’s education session.

     This blog has come to an end and I hope everyone enjoyed my teaching/lesson plan. Good luck to all of you!

As Always, Panthera!

                                References

Myers, P., R. Espinosa, C. S. Parr, T. Jones, G. S. Hammond, & T. A. Dewey. (2012). The Animal  Diversity Web (online). Accessed at http://animaldiversity.org.

Rehabilitation Standard of Care. (2011). Retrieved from www.thedacare.org (intranet).

Survey Results & Discussion Questions

Hi All,    
    At first, I wanted to present the entire PowerPoint presentation to all of you but since it is quite lengthy I will display the results of the survey.  They are as follows:

*59% of nurses reported the most difficult was in 3 of the 9 cognitive component responses: visual field testing, expressive and receptive aphasia’s, cranial nerve deficits.

*35% of nurses reported the most difficult in 5 of the 9 cognitive component responses: MMT, neuroanatomy terms, cognition related to time, memory loss, and section of the spinal cord.

(Survey, retrieved and created from http://www.surveymonkey.com/)

     I also wanted to point out what the pie chart indicated. It is evident that the part of the assessment which most often gets missed is the pupil eye assessment/reaction and tracking; equalling 38%. That percentage is quite bothersome to me, when in fact, this staff works entirely on a neuro unit.

       I think it is important to discuss the evaluation of the learner's achievement, as well.  The outcome(s) of teaching should be the completion of the course goals and objectives as evidenced by the assignment (simulation) and discussions generated from the nurses/staff.  The choosing of teaching goals and objectives fit well within the appropriate Bloom’s taxonomy as evidenced by “knowledge, comprehension, application, analysis, synthesis and evaluation” (Bradshaw & Lowenstein, 2011, p. 559). “Reflection is both an ongoing process and a critical evaluation of what has already been done. Reflection involves both thinking and evaluation, creatively and systematically, in order to come to a deeper understanding” (Bradshaw & Lowenstein, 2011, p.149). Related to the evaluation of the learner’s achievement, the following questions are to be considered:

1.      (Course goals) Does the professor have clear goals for the course? If so, are the goals communicated to you (the student)?  The rationale is that according to a research study that was done, "K.L., Weick studied perceptions of both students and nurse educators to determine qualities each group would find most desirable. From her research, Weick concluded new student nurses want instructors they can approach and instruction that is clear and concise," (Weick, 2003).

2.      (Development) What changes would you suggest for this course? (Department of Education, 2002).

3.      (Student outcomes) Have you (the student) made progress toward achieving course goals?



I know this pie chart may be alittle larger than normal (but I bet the size got your attention, though, LOL!); I wanted you to see the actual parts and percentages. 

So long for now. . .

Panthera!

                                                                     References

Bradshaw, M. J., & Lowenstein, A. J. (2011). Innovative teaching strategies in nursing and health professions (5th Ed.). Sudbury, MA: Jones & Bartlett.

Department of Education (2002). Formative Evaluation Plan for Teaching. Retrieved from http://www.denison.edu/offices/provost/education.pdf

Survey.(n.d.). Retrieved from http://www.surveymonkey.com/

Wieck, KL (2003). Faculty for the millennium: changes needed to attract the emerging workforce into nursing. Journal of Nursing Education, 42(4):151-158.  Retrieved from http://digitalcommons.library.tmc.edu/cgi/viewcontent.cgi?article=1000&context=uthson_ceirpubs

SurveyMonkey.com (Example Questions Delivered to Staff)

Good afternoon everyone. . .

I promised I would display a sample of what SurveyMonkey.com could provide for you. These are the questions asked to all nurses on the unit who voiced their concerns related to the cognitive/neuro skills assessment being a job performance problem; not everyone was perfoming it correctly.

Could this be the one and only SurveyMonkey? (No, I don't think so....lol!)

  

                                                        References
Monkey.(n.d.). Photo. Retrieved from http://www.funnyfreepics.com/
Survey.(n.d.). Retrieved from http://www.surveymonkey.com/

That's all I have to say for today, so until next time. . .

Panthera!

Learning Principles

Hi again,

In this blog, I want to discuss learning principles. Not only is the material presented important for staff, it is also important that the instructor be aware of how his/her material is delivered. There are many good principles to choose from. There will be three learning principles emphasized in this teaching plan.  First, instructors need to make clear expectations of what they want from students. If they want students to achieve at high levels, then we need to define what we expect students to learn (University of Pittsburgh, 2010). What the instructors expect need to be communicated clearly so students can achieve their best.  As we all know, sometimes that does not always occur. As students understand and visualize the criterion needed to meet the standards, in turn, they can see their goals attained.

Secondly, positive reinforcement is another learning principle. It is related to teaching new skills which lead to continued positive behavior.  The rationale is that “instructors need to use reinforcement on a frequent and regular basis to help the students retain what they have learned” (Lieb,1991, para.19).

 The last principle is retention. Students must retain information from classes in order to benefit from the learning. “The instructors' jobs are not finished until they have assisted the learner in retaining the information. In order for participants to retain the information taught, they must see a meaning or purpose for that information. If the participants did not learn the material well initially, they will not retain it well either (Lieb,1991, para.20).

                                                                      References

Lieb, S. (1991). Principles of adult learning. Arizona Department of Health Services and South  Mountain Community College, VISION. Retrieved from http://www2.honolulu.hawaii.edu/facdev/guidebk/teachtip/adults-2.htm

University of Pittsburgh (2010).  Learning Research and Development Center, Pittsburgh, PA. Retrieved from http://ifl.lrdc.pitt.edu/ifl/index.php/resources/principles_of_learning

We are coming closer to the end of this topic, I will see you all tomorrow. . .

Panthera!

Teaching Strategies

There are many strategies which may be utilized in a student centered learning environment. Some of them chosen would be problem-based learning, and role playing. Problem-based learning would provide interaction with the (nurses) as well as demonstrating the assessments with one another as evidenced by role playing. “Role play provides immediate feedback to learners regarding their success in using interpersonal skills as well as decision-making and problem solving skills"  (Bradshaw & Lowenstein, 2011, p.186). This would be the time to apply their assessment skills and discuss problematic findings. The rationale is that “this teaching/learning strategy focuses primarily on the process. A small student group works on a case study with the help of a faculty facilitator. This strategy links theory with clinical situations and encourages reasoning in a clinical situation using collaboration and negotiation within the group” (Bradshaw & Lowenstein, 2011, p.57).

Using a power point presentation, for example, will illustrate the steps going through each assessment as evidenced by pictures and words using to describe each. The power point presentation would give a clear, visual, concept of the assessments. The rationale provides a way to connect concepts, allowing the student to visualize during the learning process.  I will provide a PowerPoint presentation for everyone's review later on.

 “Many times new meanings are constructed about events or objects based on the students’ prior knowledge” (Huycke  & Fisher, 2003, p. 313). “This focuses on helping students to reason, prioritize, and link the various components to a patients’ problem with nursing actions. This simple but effective teaching/learning strategy requires students to develop word pictures for a specific patient problem” (Bradshaw & Lowenstein, 2011, p.58). 

Lastly, nurses will illustrate a scenario similar to one practiced in their daily clinical environment (simulation). I feel this activity will indeed provide nurses with the correct performance of a cognitive/neurological assessment and/or will allow room for improvement for those who need further education. “Simulation used in conjunction with role-playing clinical situations involving patients, families, and staff may provide an orientation to situations they may face in the clinical area, and allows students to problem solve in a safe environment” (Bradshaw & Lowenstein, 2011, p.173).

                                                                 References

Bradshaw, M. J., & Lowenstein, A. J. (2011). Innovative teaching strategies in nursing and health professions (5th Ed.). Sudbury, MA: Jones & Bartlett.

Huycke, A. & Fisher, M. (2003). Instructional tools for nursing education: concept maps. Nursing Education Perspectives, 24(6): 311-317.

See you next time!

Panthera! 

Final Component (Spinal Cord Assessment)

Hello again,

We are finally at the end of the last component, the spinal cord assessment.

Spinal Cord Assessment:
The spinal cord assessment (right and left function) material will be covered (Appendix E). Reviewing the content on the Appendices A-E, and assessing one level and the level below on the spinal cord assessment (SEE CHART) will be focused upon. There will be no need to do all levels for each patient since each patient’s level will vary. Re-examination, the depth, and frequency of the cognitive/neurological assessment will again be reviewed and summarized related to ThedaCare’s rehabilitation standard of care  (Cognitive/Neurological Assessment, Center for Rehabilitation, 2011). 

LEVEL	ASSESSMENT
C-3, 4, 5	Ask patient to take deep breath (diaphragm)
C-4	Ask patient to shrug shoulders (trapezius
C-5	Ask patient to abduct arm 90 degrees & bend elbow
C-6	Ask  patient to cock wrist up
C-7	Ask patient to straighten elbow (tricep)
C-8	Ask patient to touch fingertips to thumb; handgrasp
T-2,3,4,5,6,7,8,9,10,11,12	Ask patient to tighten abdominal muscles
L-1, 2, 3	Ask patient to bend at the hip
L-2, 3, 4	Ask patient to straighten the knee (quadriceps)
L-5, S-1	Ask patient to bend big toe toward head
S-2, 3, 4	Ask patient to tighten anal sphincter

                                                                    Reference

Cognitive/Neurological Assessment, Center for Rehabilitation.(n.d.). Retrieved from http://www.thedacare.org/ (intranet)

Next time we meet, we will discuss the teaching strategies that are involved.

As always,

Panthera!

Neurological Assessment

Hi All!

     The continuation of the last post, following the ears, eyes, nose and throat assessment will be the neurological assessment (Appendix D). Observation related to the neurological assessment should be an observation with no neurological deficits, or if the patient denies problems; documenting other findings may be needed. Material related to neurological deficits will be discussed, for example, observing the patient for an asymmetrical smile (1 side of mouth not equal to the other), blurred vision, difficulty swallowing, diplopia ( seeing a single object as 2 or double vision), left eye deviates downward, left eye deviates upward, left eye deviates left, left eye deviates right, left field cut, left hemianopsia (loss of ½ of a field of vision), left neglect, ptosis (drooping eyelid), right eye deviates downward, right eye deviates upward, right eye deviates left, right eye deviates right, right eye field cut, right hemianopsia, right neglect, tongue deviates left, tongue deviates right, or unequal hand grasps.   

     Material covered will also include types of seizure activity. Grand mal seizure (loss of consciousness and violent muscle contractions); this type is triggered by low blood sugars or a stroke. Petit mal is a staring spell which last less than 15 seconds, and is known as an “absence seizure" (Cognitive/Neurological Assessment, Center for Rehabilitation, 2011). Monitoring the seizure and documenting the duration (time) and length of the seizure is important and this information can be given when the physician is contacted.

                                                               Appendix D 

Neurological Assessment:

Neurological: there should be no neurological deficits, the patient denies problems, although document other findings.

Neurological deficits: Observe patient for asymmetrical smile (1 side of mouth not equal to the other), blurred vision, difficulty swallowing, diplopia ( seeing a single object as 2 or double vision), left eye deviates downward, left eye deviates upward, left eye deviates left, left eye deviates right, left field cut, left hemianopsia ( loss of ½ of a field of vision), left neglect, ptosis (drooping eyelid), right eye deviates downward, right eye deviates upward, right eye deviates left, right eye deviates right, right eye field cut, right hemianopsia, right neglect, tongue deviates left, tongue deviates right, or unequal hand grasps.

Seizure activity:  grand mal (loss of consciousness and violent muscle contractions); this type is triggered by low blood sugars or a stroke. Petit mal (staring spell which last less than 15 seconds; also known as an “absence seizure”).

Seizure duration (time): monitor and document the length of the seizure (Cognitive/Neurological Assessment, Center for Rehabilitation, 2011). 

                                                                         Reference

Cognitive/Neurological Assessment, Center for Rehabilitation, (2011). Retrieved from www.thedacare.org (intranet).

*If you have any questions thus far, please feel free to ask. I am interested in your comments and thoughts as well!

 Have a great day! . . Panthera!