Last week on Facebook and YouTube Live, I continued my series on trending topics in nursing education, responding to questions that have generated significant discussion by nursing faculty in the Facebook Group Teachers Transforming Nursing Education. 

This post was very powerful:

“I almost quit being a nurse after 5 years. I was overwhelmed, understaffed, and burnt out trying to take care of my patients the way I had been taught. I got into nursing to make a difference in people’s lives. I had a supervisor on the night shift whom I shared my feelings with. She said something that changed my nursing career. 

She said, ‘Christie, you can’t make a difference in all of the patients you have been assigned, but you can pick one patient/family and do something life changing for them.’ I’ve since followed that advice and it was revolutionary. I now have had to do that same thing in academia. I give all of my students my best, but as I have a chance, I pour into those who need extra help or at the moment find them in my presence. It feeds my soul.” — Christie C.

Remember that even if you only make a connection with one student, you are making a difference. 

Stay true to your “why” as an educator—the reason you got into nursing education in the first place. Be faithful and true to the reason you went on this journey. Don’t let the challenges you are facing today keep you from your purpose.

And don’t forget to draw upon your colleagues and support each other. 

Learning from Student Evaluations

The end of the school year for some is also time for student evaluations which can be painful at times. One educator in the Facebook group commented:

“How do I overcome student evaluations of me! It seems to be always that one who says the absolute worst and untruthful things in an evaluation. I am working with the class today, trying my best to be sweet as pie! Do I confront her about it? It’s so far from the truth!” —Suzanne A.

It’s important to reframe how you view student evaluations. Think of them as an opportunity to reflect. Here’s how other educators responded:

• You need a teaching/mentor relationship and if all comments are stellar, you aren’t learning and growing. It’s not about being liked by your students.
• I focus on the things that I can change. You can’t please everyone. The highest compliment is she’s tough but fair.
• Look for the trends in feedback. Not just one. Look for themes and use the curve model as a rule of thumb. Let the outliers go—focus on the 80% and keep them engaged.
• Look for room for growth.
• My first year, some evals were very hurtful and untrue. But I decided to take the critiques I thought I could improve on and work on those. You just have to do your own self-evaluation. If I know I have done my best and improved in areas that I need to, then I’m at peace with that.
• Conduct mid and end of semester student evaluations with questions focused on student reflections that promote professional development. Solicit feedback at multiple time points and educate students on the purpose of student faculty evaluations.

My students resisted active learning when I first implemented it, but it was the best thing for the students and they eventually embraced it. 

Evaluations offer an opportunity to give students guidelines to be respectful and civil. If students have significant concerns about your teaching, they should be told they should address concerns with you during the semester. 

Sometimes student evaluations carry too much weight in nursing education. Peer evaluations should be given more weight so educators have more control of their teaching and in control of their destiny as educators.

Preparing for Next Generation NCLEX

I recently asked the Facebook group, “What questions do you have about Next Gen NCLEX?”

Here’s how some responded: 

• “I’m scared of Next Gen. It’s going to be a challenge.”
• “What’s the best way to incorporate Next Gen in the curriculum and when should they be implemented?”

Don’t be afraid. Just remember that above all, we’re not teaching to the test, but preparing students for practice. A few important tips:

• Use case studies that use higher level clinical reasoning that leads to clinical judgment.
• Bring context to your content. Students remember concepts that are tied to a memorable story or situation. 
• Share a one image cue: Give students the “need to know” concepts and then ask four reflective questions (from Tanner’s Clinical Judgment Model).
  • Noticing: What do you notice? What are you concerned about?
  • Interpreting: What is your interpretation? Is this finding expected or unexpected?
  • Responding: What is the response by the nurse? What is the nursing priority? Do we have a problem yet?
  • Reflecting: Did the patient respond as expected? How will the nurse know if the desired outcome was achieved?

What is the best way to start incorporating clinical reasoning in nursing fundamental clinicals?

• What we must do is bring in Tanner’s framework and always ask the four clinical reasoning questions based on each process in every clinical/case based scenario you present.
• Students must learn to think like a nurse but also care like a nurse. Caring and engagement influence HOW clinical cues are ultimately interpreted. The disengaged nurse is more likely to miss relevant cues or minimize them.
• Tanner’s judgment model is practice based. If students are prepared for practice, they will be prepared for the Next Gen NCLEX.

Closing Thoughts

1. Remember your why. Develop your personal mission statement and know your purpose.
2. Teach students to be prepared for practice using Tanner’s Clinical Judgment Model rather than focusing on the Next Gen NCLEX and the NCSBN 6 step model. Remember that this model is only a test model to EVALUATE clinical judgment, NOT inform practice. Use Tanner’s framework as BOTH a curricular model and framework to develop clinical judgment since it is derived from practice and evidence-based. 
3. Let the change in nursing education begin with you! Role model what you want your students to become to make a lasting impact and leave a legacy!

To learn more, watch this video:

Related Reading

• What is Your WHY as an Educator? (and Why it Matters!)
• What to Do About Those Negative Comments on Course Evaluations
• Developing a Personal Mission Statement 
• Thinking Like a Nurse: A Research-Based Model of Clinical Judgment in Nursing
• Understanding Clinical Judgment 
• Why You Don’t Need To Worry About The New Clinical Judgment Measurement Model From NCSBN To Prepare For Next Gen NCLEX