Nurse educators face the incredible challenge of preparing diverse learners to care for patients with increasingly acute and complex needs in an overburdened healthcare system. This challenge is intensified as we prepare for the upcoming Next Generation NCLEX® changes, create solutions to tackle high rates of medication administration errors, and expand and accelerate nursing programs to mitigate the nursing shortage. And now, the pandemic tied to the novel coronavirus, SARS-CoV-2, has forced us to rapidly transition to even more virtual learning.
There is growing use of online learning tools to supplement learning in response to these issues, and learners now have a wealth of on-the-go educational tools adapted to their unique learning preferences available at their fingertips. How do we as nurse educators facilitate clinical judgment in the online learning environment?
Encourage Active, Problem-Based Learning Solutions
The link between active, problem-based learning and improved critical thinking is vastly supported in education research. Online tools that equip learners to self-direct their learning and challenge them to solve clinically-relevant problems improve lifelong learning skills and clinical judgment—two vital components of a successful nursing career. When researching online learning tools, look for solutions that allow learners to easily assess their performance to determine areas of strength and weakness and to customize remediation. Also, encourage use of resources that allow learners to apply their learning in a variety of scenarios that mimic real-life patient care decisions.
For example, UWorld’s Clinical Med Math QBank presents learners with unfolding case scenarios that require them to think about dosage calculations in a clinically-realistic way. Whether they must provide a second check on a high alert medication or reprogram a pump with a different dosage of the same medication, learners not only calculate a dosage, they must use their clinical judgment to make medication administration decisions.
Collaborative learning promotes engagement and improves critical thinking and communication skills. Although you may not be physically present with learners, it is important to maintain regular interactions, as you would in a class meeting. Utilizing strategies such as generating discussion and providing prompt feedback in the virtual environment allow you to assess learning, correct misunderstandings, and offer your support and presence. Solving a clinical problem in the online environment with learners allows you to ask probing questions to emphasize important learning points and tease out additional details to improve clinical realism, which aids in the development of clinical judgment. Offering mini-live question review sessions or creating a forum to discuss a “problem of the week” are simple ways to promote collaboration.
Emphasize the “Why”
A critical component of developing clinical judgment is understanding the “why” or rationale for clinical decisions. The “why” promotes higher levels of thinking within Bloom’s taxonomy by challenging learners to apply their knowledge in light of the individual patient’s experience. Understanding the “why” allows learners to generate hypotheses to explain clinical cues, as outlined in the NCSBN Clinical Judgment Measurement Model (CJMM). Online tools that describe the key connections between concepts provide the building blocks for learner understanding and application.
Our calling is to prepare the next generation of nurses, and part of that role is to guide our students in selecting the best available resources. As you navigate the sea of online learning tools, it is helpful to remember these core educational principles—promoting active learning, encouraging collaboration, and building critical thinking through the “why”—remain true regardless of setting.