It is a goal of nursing faculty for students to integrate didactic content into the clinical setting. Taken one step farther, in her recent publication Educating Nurses: a Radical Transformation, Dr. Patricia Benner recommends moving toward “situated learning”, or learning that takes place in the same context in which it is applied. For example, a Clinical Activity Template that was developed around the QSEN competency of EBP required second semester pre-licensure students to research the CDC recommendations regarding prevention of catheter-associated UTIs, assess whether the facility was following the bundle protocol on their assigned patients, implement the bundled interventions, and debrief afterward. The faculty reported that this experience for the students has been far more enriching than simply explaining the importance of each intervention (or task) individually, as was the case prior to implementing the EBP activity.
During the QSEN curriculum integration process, there is even more demand to reach the goal of creating an environment or activities in which situated learning can take place. During this time, faculty is creating new learning activities, finding pre-existing activities online, and sharing ideas with each other. The Universal Template tool was created to aid in providing consistency among faculty throughout the QSEN learning activity development process and subsequent student activity assignment process. It has gone through multiple iterations since its initial design and implementation in Spring 2010. It has also been adapted and modified for use in alternative settings, such as a Professional Partnership (preceptor) Program and New Graduate RN Program.
The Universal Template tool itself provides placeholders for vital information differentiating each course, category, and activity. Clinical or course objectives may be indicated when applicable. More importantly, it provides a uniform structure, stating the faculty’s expectations in a “universal language” – the QSEN KSAs. This template also helps faculty to write more focused activities. For example, a clinical activity may help in the selection of the most appropriate KSAs, while selection of the KSAs may spark creative clinical activity ideas. Alternatively, faculty may choose to leave the “activity” box blank and require the student to show competency in that area by offering the ways in which they met the KSA criteria.
Structurally, the tool is formatted into a table, where “Knowledge” is separated from “Skills” and “Attitude”. This was an intentional and symbolic decision. Situated learning requires that students be prepared with the knowledge necessary to care for the given patient population before entering the clinical setting or during pre-conference; hence the label “pre-planning”. The “Skills” section then indicates the expectations/assignment during the students’ clinical experience. The “Attitude” section is assessed after the clinical experience is complete (either verbally during post-conference and/or written in self reflection via journals). I recommend a structured self-reflective model to organize the students’ thinking process. In our program we utilized Dr. Christine Tanner’s Model for Clinical Judgment (2006) to assess clinical judgment and competency in the affective domain. This Universal Template design and KSA format allows faculty to assess student competency in the stated KSAs, as well as providing students with the opportunity to assess themselves. The students can use this worksheet in any clinical setting to guide their experience. Instructors can likewise define this worksheet as a performance measurement or evaluation criteria.
**Note: Please also refer to the sample Clinical Activity Template (CAT) for an Evidence-based Practice learning activity on the Catheter-Associated UTI bundle, which utilizes the Universal Template as the foundation. This activity was created for second semester, pre-licensure, ADN students. It has also been submitted as a “Teaching Strategy” for publication on QSEN.org.
References:
Benner, P., Sutphen, M., Leonard, V., & Day, L. (2009). Educating nurses: A call for radical transformation. San Francisco: Jossey-Bass.
Tanner, C. A. (2006). Thinking like a nurse: A research-based model of clinical judgment in nursing. Journal of Nursing Education, 45, 204-211.
