AET/515 Instructional Plan

Jason Nichols

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Needs Assessment
1. 2. 3. 4. What is the learning problem or opportunity?
There are healthcare jobs available at the hospital, but no healthcare courses offered at North Valley Community College.

What is currently available?

No courses are currently available for the CNA certification required by Patton-Fuller Community Hospital.

What should be available?

At least a basic nursing course should be available to make Kelsey residents eligible for the job.

Explain the gap analysis between what is available and what should be available.
NVCC currently has no nursing program available. Job opportunities in the community exist for those who hold nursing certification. Offering basic nursing certification through the college will help meet the occupational needs at community hospitals.

5.

What is your recommended solution for filling the gap?

It is recommended that NVCC develop an introductory nursing curriculum which meets state licensing requirements for Certified Nursing Aids.

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Instructional Goal

Upon completion of the Introduction to Nursing course, the student will be able to safely perform the basic duties of a Certified Nursing Aid.

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Performance-Based Objectives
The student will check a patients vital signs and determine if the signs fall within a normal, healthy range. The student will demonstrate proper use of basic nursing equipment (stethoscope, thermometer, blood pressure cuff) in a simulated hospital environment.

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Summative Assessment and Learning Outcomes

Each student will be given a written examination to evaluate his or her ability to identify the parts and components of the basic nursing equipment used and to evaluate his or her ability to identify temperatures, heart rates, and blood pressures in the normal range. Each student will be given a practical examination to evaluate his or her ability to check vital signs using a thermometer, a stethoscope, and a blood pressure cuff.

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Learner Characteristics
The national average for gender ratio in nursing is 90% women, 10% men. Enrollment in NVCCs program will likely reflect the national average. Kelseys population of 625,000 and NVCCs enrollment of 5,000 students in degree programs will mean a wide variety of ethnic backgrounds seeking enrollment. There are no prerequisite courses required for the CNA certification although a high school diploma or GED are required for enrollment. Since 50% of this course includes hands-on practice, the other 50% of the instruction will need to incorporate a blend of visual and auditory instruction to balance between the three dominant learning preferences. As an introductory college course, the reading material should not exceed high school reading levels to ensure comprehension and retention of the material.

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Learning Context
Instruction for the Introduction to Nursing program will be a blend of classroom instruction and practice lab. 50% of the course will be classroom instruction involving lecture and textbook reading. Case studies will be examined to ensure exposure to as many common scenarios as possible. The other 50% of the course will be a practical application of the safe methods and procedures learned from reading/lecture. Students will work in teams to practice taking temperature with a thermometer, heart rate with a stethoscope, and blood pressure with a cuff. This practical training will be limited in that heart rates, temperatures, and blood pressures will all be in a normal, healthy range and will not reflect what could be seen in a real hospital environment. Such training will also not be able to introduce the safety hazards that exist in a hospital. Because of this, the classroom instruction will need to address identifying vital signs outside of the normal, healthy range, as well as potential workplace hazards.

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Delivery Modality
This course will be an instructor-led traditional classroom course. The majority of the students will have little or no college-level coursework prior to this course and will likely be most comfortable with the instructor/classroom setting they have been accustomed to in high school. Because the course is hands-on in nature, a physical location will best serve as the modality. The hands-on component of the classroom should be designed to replicate a hospital room (hospital bed, I/V tree, etc.) to provide the most realistic environment in which to practice the methods instructed.

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Instructional Strategies
This course will teach students how to check a patients vital signs using a thermometer, a stethoscope, and a blood pressure cuff. The procedure will be taught by instructor demonstration of the proper techniques followed by students practicing the demonstrated procedure using each other as patients. The instructor will present information from a text book to give the students an understanding of normal body temperature and heart rate as well as how a thermometer, stethoscope work, and blood pressure cuff work. Case studies will be used to show the range of possible vital sign scenarios encountered in a real healthcare environment. Additional demonstration from videos will be used to cover cases outside the normal range encountered in the classroom. Students will need to understand the range of normal, healthy body temperatures, heart rates, and blood pressures and those which indicate a health risk. Students will have an opportunity in each class meeting to practice using the equipment to check the vital signs of their peers. Students will be required to demonstrate mastery in using a thermometer, using a stethoscope, and using a blood pressure cuff. Students will be required to know the healthy ranges of body temperatures, heart rates, and blood pressures.

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Plan for Implementation

This class will meet for two hours, two days a week (Tuesday and Thursday) over the course of four weeks. The classroom time will be divided into one hour of instructor-led teaching/demonstrating, and one hour of students practicing the techniques demonstrated by instructor, using each other as practice patients.

Ideal class size will not exceed 20 students per instructor. One instructor will lead the class. Students will be required to purchase a textbook and, a stethoscope. Thermometers and blood pressure cuffs will be provided for classroom use at NVCC. Case study DVDs (approx. 30 min) will be used to show the rare and extreme vital sign cases. Other videos will be used to demonstrate taking vital signs of special cases (invalid, comatose, morbidly obese, etc.) which students will not see firsthand in their peers. Case study videos shown in class will be made available in the library for review. The classroom will need to include a hospital room simulation and include blood pressure cuffs and thermometers. Each of the vital sign segments will be covered in two class periods (body temperature/thermometers in Week One, heart rate/stethoscope in Week Two, and blood pressure/cuff in Week Three). The final week will include a written exam on Tuesday and a practical exam on Thursday. The course will be offered twice quarterly on the NVCC-Kelsey campus.
Initial implementation of the course will involve both design and expert reviews by licensed nurses to ensure the course meets the necessary guidelines for nursing professionals. It is recommended that a pilot course with 10 students and one instructor be implemented first with formative and summative evaluation data collected and used to determine the final design of the course content, length, and materials used. NVCC should develop a partnership with Patton-Fuller Hospital and collaborate with Patton-Fuller nurses for the expert review and to get input from the hospital as to what is expected of new-hire nurses. If the hospital is given opportunity to weigh in on course content, they will be more likely to support the program knowing that NVCC will be able to provide work-ready nursing aids who meet hospital criteria for employment. Participants who meet the enrollment requirement of a high school diploma/GED will be selected on a first-come basis.

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Instructional Resources

The course will require a classroom with whiteboard, projector/screen/DVD player and enough desks for the number of students. Additionally, part of the classroom will require hospital beds to simulate a real hospital room. Blood pressure cuffs and various types of thermometers will be needed for the classroom. A class of 20 studentsworking in pairswill require 10 cuffs and 10 thermometers. A written exam (reviewed by a subject matter expert) will need to be created. The exam should cover: identifying the components of the equipment used; identifying the ranges of healthy body temperature, heart rate, and blood pressure.

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Formative Assessment
1) A learner evaluation will be conducted at the beginning of the course which will provide details of how much each student already knows about the subject matter. 2) A weekly quiz will be given to indicate whether students are grasping the material. 3) A weekly observation of the students employing the techniques learned will be conducted. 4) Weekly quizzes and observations will serve as a usability test and changes will be implemented, as necessary, based on the results of the quizzes and observations. 5) A student survey will be conducted at the end of the course to get feedback on the students learning experience.

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Evaluation Strategies
Weekly quiz and observation results will be evaluated alongside the results of the final exam to measure progress and improvement throughout the course. The results of the student survey will also be evaluated with the results of the final exam to determine if students felt the course helped them to learn the content of the course satisfactorily. Qualitative data (how well the students met the performance-based objectives) will be evaluated first, to determine if the instructional goal was met. Quantitative data (how many students passed the course by meeting the PBOs) will be examined next to determine overall success of the course. If a significant portion of the students were not able to meet the PBOs, specifics from the student survey will be looked at to determine what parts of the course proved difficult and may require amendment.

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Outcome Review
A scoring rubric will be used to determine how well the performance-based objectives were met and learning outcome achieved. Each component of the PBOs (evaluating vital signs for healthy/at-risk status, and demonstrating proper use of each of the three instruments) is worth one point. For the first PBO, a total of three points is possible: one point each for checking temperature, heart rate, and blood pressure. Three points are possible for correctly determining if each vital sign is healthy or at-risk (a total of six points possible). For the second PBO, one point is possible for demonstrating the proper use of each instrument (a total of three possible points).

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Recommendations
If a satisfactory number of students pass by successfully completing the performance-based objectives and the student survey results are favorable, then it is recommended that this course be added permanently to NVCCs course catalog. It is further recommended, upon the success of the course, that this course format be used to expand further coursework in the nursing field toward a certificate or degree program in nursing. Collaboration with Patton-Fuller Hospital is recommended to ensure that the problem-based objectives for this course (and any subsequently designed courses) continue to meet the hospitals expectations for nursing assistants.

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References
Alexander, C., Praeger, S. (2009). Smoke gets in your eyes: Using rubrics as a tool for building justice into assessment practices. Australian Teacher Education Association. 1-13. Retrieved from http://www.eric.ed.gov/contentdelivery/servlet/ERICServlet?accno=ED524704 Brown, A., Green, T. (2006). The essentials of instructional design: Connecting fundamental principles with process and practice. Upper Saddle River, NJ: Prentice Hall Instructional Design Expert.com. (2010). The Analysis Process. Retrieved from http://www.instructionaldesignexpert.com/analysisProcess.html

Peterson, C. (2003). Bringing ADDIE to life: Instructional design at its best. Journal of Educational Media and Hypermedia. 12(3), 227-241. Retrieved from EBSCOHost database.
Stull, J., Varnum, S., Ducette, J., Schiller, J., Bernacki, M. (2011). The many faces of formative assessment. International Journal of Teaching and Learning in Higher Education. 23(1), 30-39. Retrieved from EBSCOHost database.

Williams, D., South, J., Yanchar, S., Wilson, B., Allen, S. (2011). How do instructional designers evaluate? A qualitative study of evaluation in practice. Association for Educational Communications and Technology. 59, 885-907. Retrieved from EBSCOHost database.

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