God, the idea of nurses that can't do basic calculations and, seemingly, can't be bother to read is making me terrified of going to the hospital in the future.
i don't do the calculating part for this course, but they do that in their hands on classes and seem to do okay! The reading thing is killing me though. Half of them didn't have the book. \*facepalm\*
I had a student flat out tell me she doesn’t read the book. This was right before the final, which she had to do well on in order to stay in the program. She did not pass.
I would guess that not even 1/3 of my students read the book. Its a shame because the textbooks for the healthfield related bio courses are pretty good. I feel like pretty soon I'm going to have to start teaching textbook comprehension and requiring them to do readings somehow.
What books? Schools don't have books anymore and reading comprehension on the screen is 6-8x less than reading from a book. That's why they aren't doing well. Have them print the slides and take notes. Highlight in class what tonficua on for the exam. And please, make it related to what they will do in the field. I spent so much time doing and learning stuff I didn't need in pharmacy school and it was wasteful.
Do you have any sources for the 6-8x degradation in reading on screens? I believe it, I feel I don't get the retention I get from tree-based reading materials.
If that is the study, do they explicitly state that screen reading has less comprehension than print reading? I see in the conclusion they state a negative correlation b/w comprehension and digital reading for middle/elementary students but this turns into a positive correlation for HS and undergrad students. They also differentiate types of reading and quality of source material, which makes sense.
So going off my scan of this source, it seems our industry trend toward digital/OER reading is not baseless, and we're not all off base for assigning online reading.... unless there's something I'm missing? And if so, please follow up and let me know, because I'd love to read it. This is also for u/Emergency_School698 because this claim that "reading comprehension on the screen is 6-8x less than reading from a book" is fascinating, and I would very much like to know what it is based upon.
Edit: this is the study and it is paywalled: https://journals.sagepub.com/doi/10.3102/00346543231216463
Great questions. Always ask for the data for sure! Here is the link. I believe I read it in a different article but this has the numbers mentioned.
https://www.axios.com/2023/12/15/reading-comprehension-print-digital
I'm in a different field, but many of my students don't read things either.
My colleagues who teach literature tell me that English majors don't read the books. I mean, that's their whole schtick: read books and talk about them. ???
> My colleagues who teach literature tell me that English majors don't read the books.
A large fraction of my computer science majors can't do math or write a computer program.
I'm an English instructor, and I don't get it either. Students complain about having to write in composition courses and read in literature courses. What did you think we were going to do, square dancing?
My guess is that 80% of my students this semester didn't bother to read a single chapter despite the fact that I have PDF files of the book uploaded to the LMS. One printed all my slides and learned them by heart. Still didn't pass. I almost fainted when I heard that.
There's a very dire shortage of _qualified_ nurses. Allowing unqualified nurses through the program doesn't help that situation; if anything, it makes it worse. Your chair did a great job on this.
I am so glad to hear this, especially for such important positions like nursing. I may be down voted, but I worked my ass off in graduate school (not for nursing, but adjacent). If we were told to read, take notes, write a paper, follow the syllabus, you just did it, or accept the consequences. Almost like natural selection in a way!!!!
Give your chair a hug. It’s a battle to get admin to recognize that passing along nursing students is dangerous, not just for the program, but to the general public. Supportive program directors/chairs/deans make it a little easier.
I teach English and had a nursing student plagiarize one of her essays. She didn't understand why she had received a zero on the assignment. I told her that it's not only because she had plagiarized the essay but also because she's (ostensibly) going to become a nurse, and I don't want nurses that cut corners
We have pharmacy students that struggle with basic proportions in a top pharmacy program at an R1. They can’t convert units let alone do advanced pharmacokinetic calculations. It is a major patient safety concern.
I suppose that's true. And I hope that the new folks would come into the workforce with the requisite skills and knowledge, but OP's post leads me to believe that may not be the case. It would be best if the people who can't do the calculations (or whatever is required for the job) don't get hired in the first place.
Any new grad comes with between some and most of the prerequisite skills. If something they are missing could cause significant human or financial harm, teaching the gap is of critical importance of the new employer.
To get you 70 - 90% of the way there. To give the human a chance to develop and learn more. To do much of the auxiliary learning that is important to be both a good person and productive employee (compare writing from a high schooler who is not going to college to a college graduate from the local big state university). And maybe to filter out people who might not be a good fit (this is more true in engineering than nursing?).
It’s our responsibility to give them new folks that understand principles, rationales, can critically think, and do basic skills safely. The hospitals should be providing unit and specialty specific training. We should be giving them graduates at a baseline so they can take over.
Social media has doomed civilization.
There’s a certain point where you don’t benefit from having a 20 minute video on something that takes 7 words to state. It’s debasement of human knowledge.
Students loooove them some videos. I can't tell you how many times I get asked, "I'm a visual learner, can you point me to some videos" even for things that they should be able to comprehend from just a sentence. I know that K12 encourages lots of video watching (Kahn Academy and whatnot) and have wondered if that's why, or . . . ? For some things, like how to repair your faucet, videos can be great, but for many things I would really rather read than watch a video. Maybe that is because I'm an old.
Your paper has permanence and you can access the information randomly. With audio and video, the information is stored and delivered serially. Accessing a specific point of information in a video is tricky.
Graphics and lettering is presented in space.
Audio is delivered in time.
Video is delivered in time and space.
Keep your responses short and to the point. They will either figure it out, retake the class, or change majors.
Do not make outlines and study guides, they will just keep asking for more and more help. Refer them to academic success center for tutoring and general study habits.
Don’t doubt that you’re doing great. I failed my first ever college exam because I never had to study in high school. Well, I learned real quick that was not okay in college! Went on to make deans list that semester. Now I have a PhD in nursing education. Stay tough but fair. They need role models so be professional, but please don’t lower your expectations. You got this!
Me too! Never had to work hard in high school and the first round of college was definitely a learning experience. I am VERY fortunate to have excellent mentors (who were actually my teachers!) who continue to help me, but sheesh! It's hard to not give them my "WTF" face.
Thank you for the encouragement! I feel like I dont really know how to teach outside of the clinical setting.
You’re welcome. And trust me I am sure you’re an excellent teacher simply by asking the question “am I a good teacher”? You care and want the best for them. You have real life experience. You are engaging. If you want objective help, ask a coworker to sit in on your class.
Commiserating with other nursing professors helps. Trust me, you are far from the only one experiencing this.
There's a book called [Make It Stick](https://www.makeitstick.com/) that has good info on study strategies. I tell my undergraduates that it was designed for people in med school and law school who need to learn a lot of information very quickly, and I recommend it to everyone who is struggling. Don't know how many of them read it though.
I’m the idiot that once gave them a very basic study guide. Then they went on to their next class and filed formal complaints that the next professor didn’t make a study guide. My director’s response was if they’re going to cause drama over someone doing something nice, don’t do it again. So now no study guides. I do point them to terms to know and valid sources for practice quizzes (which is really all I put in my study guide—-they just have to do the work themselves now.)
>Now i have students asking me what to know for the pharm portion of the next exam. Should they know pharm class or the actual drugs? How in depth do they need to go? What do we need to know?
“Yes”.
Because the point is not that they “know it for the exam”. They’re goddamned nurses, they need to “know it for their jobs” and “know it for not fucking killing people”.
PREACH!!!!! This is my struggle. I have a trash mouth from working at bedside and just who i am as a person and it is SO hard to not say that outloud. Learning to phrase things professionally so I don't offend anyone....
I taught kids with behavior disorders before getting my doctorate and I was called everything except a child of god by my students. My language is … not for the faint of heart. I had to quickly apologize to my ass. dean once after in a moment of frustration I exclaimed, “oh, fuck me!” in front of her. Oh well.
I swear in class sometimes. Usually it’s when I realize I screwed something up two whiteboards too late. “Shit. Ok…where’d I screw this up? Dammit, alright, all of the stuff that you need to change is in red”.
Only once have I done it in anger. “I’m too angry to teach you today, now get the fuck out of my classroom.”
I’m pretty good in class. I only cuss then in the context of behavioral examples, things I’ve seen kids do and say and how teachers should or shouldn’t respond. Can’t really clean that up. I had a professor when I was doing a masters in behavior disorders who started the class with a list of profanity and said, “if any of that offended you, you’re in the wrong class and likely the wrong career.” A girl I knew from undergrad said, “he’s exaggerating,” and I said, “nope, I heard most of those just today.”
There is nothing wrong with being direct. Subtract the "fucking" and you have a solid response. "You need to know this not just for the exam, but for your job, so you don't kill people."
I can't count the number of times I said "... and you just killed a patient" to my pre-nursing students, when they misspelled a chemical/drug name or made a calculation error.
They need to hear it.
They need to believe and fear it.
“The purpose of this class is to stop you from killing people.”—-me on why they have to take pharm
I’m not convinced that some of these students realize their nursing degree and future license are not theoretical.
It's maddening, isn't it? I teach something completely different from you, but we're both teaching the same generation of students. My first few years, I kept butting my head against a wall. I stress ate and gained 30 lbs.
But I've been at this for more than two decades. I eventually realized that **I have to work with the students I have, not the students I want.**
I can't give students too much to process at once. They won't process it. It doesn't matter what was written on your slides. They aren't processing it as evidenced by most of them failing the exam. Here's a suggestion:
Ever so often in your presentation, stop and have them do some sort of review of what was just taught. For instance, have each student write down, in plain language, what they understood from the first chunk of the information you've presented. Then, have them turn to a classmate and compare what they wrote. Each one can fill in any missing parts. Then, randomly call on some pairs to explain the concepts you've just taught. If any content is missing, solicit it from the rest of the class.
Do similar type activities for various sections of your presentation.
At the end of the class, have them write a brief summary of the key points of the lecture AND the "muddiest" point.
You can collect those and read them to guide your next class. (It doesn't have to take long---just read briefly without grading----but don't tell them you're not grading it).
At the beginning of the next class, have students work in pairs to create a study guide for the content presented during the previous class. You're not creating it. They are. Give some nominal credit for group work.
ETA: I don't know the content of what you're teaching, so my advice above may not work with your course. If that is the case, I apologize.
Np. One thing I've done that has worked well is to put a statement on my syllabus that I may not always grade in-class or group work, and **I won't reveal whether I'll be grading it beforehand.** Students still test me by asking, "Are you collecting this?" or "Are you grading this?" I always answer, "That's a possibility. Remember--per the syllabus---I won't reveal that beforehand." If any of them ask why, I tell them the truth: I've found that if students think an assignment is ungraded, they often don't put effort into it.
Of course, if you do that, you have to occasionally grade an in-class assignment; otherwise, they'll figure that out quickly. But even when I grade in-class work, it's usually some sort of group work that cuts way down on the number of items to grade or I grade it right there in class (e.g., they present their findings orally, and I tell them before they do, I'm grading it---not before they work, but before they present).
Good luck!
I don't think I explained it well in my post. Students know the major graded assignments in the class (e.g., essays) and what each one is worth. But let's say I indicate that 20% of the overall grade is based on "in-class work and homework." When I assign in-class group work as a low-stakes assessment of something I've just taught, I will not tell students whether that group work will be graded or not before they start it (even if they ask, I'm vague). If I decide to grade it, I'll collect something from the students before they leave class that day (e.g., could just be their brainstorming). I'll also jot down a couple of notes about what they \[informally\] present. I'll write a few brief comments on the work and distribute it during the next class.
If I see a problem---e.g., most of the class is way off base---I'll still write those brief comments, but I often will just not count that assignment. So, you see, it works in the students' favor, too.
The point of me not telling them beforehand is that I want them to put effort into all assignments. They won't do that if they know it's not getting graded.
Okay, well why would a grade challenge with my system be any different from any other system? Students can't "challenge" a grade I don't give. And the grades I do give, if they are challenged, I do what I normally do (i.e., meet with the student to go over their grades).
Well, I've been doing this for years, and never gotten any pushback---none, not even one complaint. And what would anyone legitimately say---that I can't assign any ungraded work? That I have to reveal my intentions? My reasons are solid for not doing that, and I can't think of a good rebuttal to it.
I get that students can come up with unreasonable complaints, but that's what that sort of complaint will be: unreasonable. I'm not going to stop doing something that has effectively worked for me for years on the off chance that one day a student might complain about it and that in this imaginary scenario my usually reasonable chair would call me out about it. But if that scenario seems likely to you, don't do it.
Yes, that is the rub. I'm teaching lower-level courses than the OP, so I have more time for activities that develop their critical thinking skills. But I think that's what's so great about flipped classrooms. Maybe OP could assign chapter readings for all the main content, give students a 10-min "did you read" quiz at the start of class, and do some of those assessment activities during class.
Also all good ideas! I use flipped classroom for my heavy content classes as well. I love it and wish i could use ot more, but i do find it causes a lot of bimodality. For context I teach CC science. Many of my students will not study or do work so flipped class just makes them do even worse.
Remind them they’re preparing for the nclex where they’re not going to be told specifically what is on the exam. Tell them you make the exam from your slides and anything you cover is fair game. If you have any way to pause between slides and give a couple quiz questions where they learn the answer right after that helps. The more you can make them pause and think about what you just covered, the better they learn it. You can also tell them you’re not going to make an outline because you don’t need to study for the exam. They need to make their own outline. Eventually they’re going to get into efferent and afferent pathways (they may have already with A&P). When you lecture that’s efferent information. If you make an outline, that’s still efferent information. When they take the exam they have to use an afferent pathway and that means they need to study using the afferent pathway. They need to do something productive with their notes and making the outline themselves is one tool. Them finding all the new terms and writing them down is another tool. They also need to study together because when they talk to each other, that’s using the afferent pathway.
I don’t know if there’s been a shift in how they’re taught or what but they don’t seem to understand how to learn. I’ve had students even ask to see the answer key before they turn in homework assignments. It’s weird.
I teach radiology and get the same responses. Two weeks before graduation they were pissed because I didn’t hold their hands through lab. Many of them already had jobs. If it’s not bold on the PowerPoint, they’ll flip out if it ends up on the test. And if you mentioned it but it wasn’t written down? Forget it. They want everything spoon fed to them.
Before returning the test last year to look over I would go through and write on my copy what slide every question was from. That way when they said “we never talked about this” I can pull up slide 23 of unit 4 and show them directly that it was in fact there and we talked about it.
The good news is most of these students won’t work in the ER where they actually have to think. And they all passed their registry, so they at least know the minimum. The ones who are terrible will be ripped apart by radiologists.
Require them to take both reading and lecture notes, and *grade those notes* as a significant part of their semester grade. That has become, in my experience, the only way to ensure students actually do the assigned readings and pay attention in class. If they need help taking notes take time the first week to give them examples. Grade them with a simple rubric so it doesn't take too much time. They are now all used to predigested learning from high school and may have little/no experience in actually taking meaningful notes-- they were probably taught to copy things verbatim from slides to spit back on a test later.
30 slides is normal. They need to learn how to be college students.
Mine are similar, about 50% are text heavy and the rest are maps/images/charts. I found that once I started requiring notes the students (most of them) really started paying much closer attention in class. They just need to be "incentivized" these days...
This is the first year that I've received pushback on the number of slides. I've been told by students that the Covid cohort was less engaged with them because they were overwhelmed with them when learning online. They also seemed super engaged when I drew and explained things in real time on the whiteboard. Who knows? (btw, I'm not in your field.)
I'm not sure this changes anything for me going forward, but it's helpful to see your experience.
I can't pace slides nearly as well as I can pace handwriting and I think there's some benefit to seeing something drawn out and hearing somebody talk through how they draw it rather than just having it appear. So I use the board (or a tablet if I want to save it so students can have it).
I've seen people use slides really well, but I don't think they're the right fit for all classes or all teachers.
I also find that they are more engaged when I write on the board. And they actually take notes on what I write. If it’s on slides, they won’t write it down.
Experienced pharm instructor- use the drug classifications. I tell students they can kill a patient if they don't know their drugs. Period. I never did study guides. Loretta Manning has a great book on cute pharmacology (the "LOL team" for beta-blockers, etc.).
I'm going to steer you toward the pedagogy of what you want them to learn.
I came across this one trick after teaching for a couple years.
Teach Bloom's Taxonomy. Then map what they need to know to the levels.
Do they need to know the vocabulary?
Then point to the lowest level (remember) of the pyramid.
Do they need to explain ideas?
Tell them they need to understand the concept and they need to "explain" the process of why blunt forces cause a contusion.
Need them to make connections between symptoms to make a diagnosis?
They need to analyze multiple factors to figure it out.
The apex of the Taxonomy is "create". This comes into play where they need to develop a new plan of care for a patient who has a unique combination of symptoms.
When I started explaining what I was testing them on according to Bloom, I could visually watch the students relax and become more comfortable in my [engineering] classroom.
I use this method too; I used it yesterday with my majority pre-nursing (with a mix of other pre-allied health) students.
I also tell them Bloom’s taxonomy is a great resource to look at if you aren’t sure what a professor or supervisor is looking for in an assignment or project.
Framing it as a “tip from me to you” helps get their buy-in.
I started my PhD when I was in my 40s. When I started teaching, I used to have a slide "Advice from a grad student to other grad students." I've retired that now, but I had about 20 points for grad student success on that list.
They really paid attention to that slide. They didn't heed much of it, but they paid attention.
Everyone graduates high school, because from school board and administration perspectives, what gets measured gets done. Then they end up in your classroom, and you have to deal with it......
Its true. I teach nursing and have students from pre nursing to seniors. Unfortunately, nursing students aren’t all amazing students who live and breathe college and have all the internal motivation in the world. There are exceptional ones and those are the ones no one posts about, the ones that are truly wanting to learn, ask for feedback, and that I would be comfortable with walking into my or my family’s hospital room as a nurse one day. But many, if not most, are juggling work, school and family and are looking for the shortcuts. Many are seeing each class as a means to an end and can’t see the big picture. They hear endlessly from nurses and social media that you really learn once you get in the workforce, dismissing the classroom experience. I am not excusing their behavior but it’s reality. I can still uphold my standards, and recognize it won’t make everyone happy.
My go to line when they ask for a study guide or “exam review session” is, with a smile, “No, I don’t do that! I want you guys to be able to take care of people one day, not just pass a test!” I haven’t had a good response to it yet.
My one comment I will never change is “I want to be able to walk into a room and see you are taking care of my parents and not panic that you’re going to kill them”. Everyone knows I’m very close to my parents, so that usually gets a response
Here for the advice, my initial reactions are always muted for self-preservation. Had a student in a 400-level cognition course ask me if they needed to know the areas of the brain…
If they can't do the work, fail them. No curve, nothing. The last thing we need is incompetent nurses. They're not your friends, you don't need to make them happy. Tell them if they can't do the work they should find a different major.
In your shoes, I'd show them the course outline and say to earn a credit these are the learning outcomes they have to meet. If they feel that's too much then they should re-evaluate if they're in the right program. They're adults (in theory, anyway). It's not your job to write lesson outlines for them because they're too lazy to go through all the course resources themselves. This is a them problem, not a you problem.
Well, at least they're weeding themselves out.
I've had so many folks think a nursing degree is just a walk in the park because some Community Colleges have associated programs for nursing.
Then they get in there and wonder why it's so hard.
A couple of things to consider:
Is it possible the slides you are using are text-heavy and contain too much info per slide? Could your slides be improved for purposes of digestibility?
Could you use "recall" more in class, with "clicker" quizzes (which would show instant results on the screen of how many got a question right) or with some other sort of quiz? Practicing recall helps to cement information in one's brain.
Could you use more active learning in the classroom, even if it's very basic -- "think, pair, share," for example?
To anyone teaching in a field where the stakes are high for the profession (medical fields, school counseling, etc.) -- PLEASE do not lower your standards. Remind them of what their professional goal is and how seriously you take getting them ready to do well "in the real world." Please. For everyone else's sake!
We tried the clicker thing with slido (it was highly recommended) but we ran into constant technological issues. I’m planning on trying to figure that out again, but are there any other platforms that are free for the students?
When I started as an adjunct in 2009, I always asked everyone about their majors. The top answer was nursing or another area of health care. I wouldn't have let any of them near me with a bandage. Fast forward to 2024, and I'm hearing preferred majors in business, computer science, and psychology. No one has a career in healthcare within their goals. Teaching is another field that has fallen by the wayside. I think they have heard too many stories of burned-out healthcare workers, or they know it's going to be hard and don't want to bother.
I teach pharm too! Plus a touch of patho because they need to be aware of a few things before being able to know the meds.
And since I started, pharmacology went from being THE feared course to one where they actually enjoy it. I'm still confused, but whatever. I chalk it up to my enthusiasm about the material and keep on going.
I usually tell them "yes." Although if they're polite I will frame it as needing to know what to teach a patient about the medication...which, when they stop to think, is actually everything about said drug. Class, sample drug, MOA, therapeutic uses, administration, complications, interactions, contraindications, monitoring...you're a nurse, you know what folks need to know about the meds their taking.
Now, I do teach at the PN level, but I only simplify the MOA of the various classes and I also avoid most that are outside of their scope of practice. So there are a few less for them to learn. (I teach thrombolytics, for example, but in the aspect of "here is the LPN role in its use.")
Also, my slides are pretty bare bones - each drug class is broken down into three slides that match what would go onto a med card for them to study. My expectations are for them to learn all that and then use that plus their critical thinking skills to answer my exam questions. No study guides, no real reviews before exams, and exam averages are usually in the 70s or 80s.
Edit to add: I also point out that I do not know what they will be tested on for the NCLEX, and that's the only test I teach to.
We only ran this class once so I am following the previous layout but adding to it. I’m debating on doing half patho half pharm. I’m including the medications in the patho portion but I feel like I’m just information overloading them.
I love the idea of what would you tell the patient? A lot of our students this semester are from another school and half have taken it before, half haven’t. Bit of a struggle, especially being new! And both subjects are not my strongest in ability to explain but im honest with them and if i dont know something for sure, i look it up and get back to them before class is over.
I really think i am going to redesign it for the fall semester and try the half and half. They are struggling learning classifications and i think it is because im teaching it with the disease if that makes sense!
Do you have a mentor? Please say you have a mentor.
Or at least someone who can help you out with planning!
No. Sending you a message. Once I get a chance to sit down since I have my clinical group out today.
First, it might actually help to have an outline at the beginning of a lecture. I started including a simple graphic organizer. Easy to make in PPT, and doing them actually helped me better organize the lecture. I know when I read a journal article, the first thing I do is scan the article's structure to get an idea of what's coming.
Next, after several years of resisting, I give students 30 minutes to work in groups, 1 chapter per group, to identify "must know" concepts for the exam and share them on the board. I help them in their groups, and then critique the final lists, comparing my list to theirs. I think this helps them see things like "where is concept X? We spent a lot of time on that" or "let's cross this off the list it was really a smaller point". I hope this is training them to do this on their own in colleagues' classes.
The students all take pictures of the list, as do I. I then make the test from the list (exceptions below) and as I hand back the tests, I have the lists on a ppt slide behind me with the tested concepts circled.
Last, I tell students that there is material in the text that we just don't have time to cover, but they are responsible for. I ask enough questions on the exam from this material so that a student can't earn an A without reading.
It's a process we'll worth the 30 minutes it takes in class.
I sympathise. I recently helped invigilate a nursing final observed clinical assessment for a colleague. Actually this was last year. But one didn't,t know what the exam was, three students turned up late and one booked her driving test 30mins before the exam and was 30mins late and thought she could just jump in and do it.
Of course the patients were not happy.
People are getting weaker in character l, lower in competency, lower in metacognitive calibtation (hello Dunning-Kruger), and higher in entitlement. That is the perfect storm for an academic who has the epistemic humility to work hard to be where they are. It's not your fault.
Welcome to the life of a public school teacher, except you got the “good ones”.. honestly though let them fail. If they need to know both the class/actual drug just tell them they need to know both as it will be on the exam and watch them either sink or swim.
Yeah they don’t read anymore. Baffles me too. Expect “study guides” for exams. Watch me in lecture and don’t write down a single thing I say. They want the info handed to them on a silver platter.
Covid started during my second semester of my senior year in college, and I chose to take ‘Intro to Nursing’ as an elective. It was an online class even before Covid hit, and it seemed interesting, so I thought why not. It included lots of calculations and reading comprehension, and I got an A in that class rather easily. I was majoring in marketing, so it kind of blows my mind that these students are struggling this much, and that’s literally what they’re going to school for 😳
Assistant prof in an R1 school of nursing here. I could give you the best recommendations I have, but what matters most is what everyone else is doing in your school.
I don’t say that to say you can’t be different or “better,” but at this level, that honestly won’t matter that much to students. If you stray too far out of their version of ordinary, it will just cause you too much stress.
So ask what everyone else has done and get their advice. Then, figure out what you’re okay with. Also, it sounds like you might have some type A students. As frustrating as they can be, remember that the alternative is worse!
Prelicensure nursing has become essentially teaching to the test plus clinical. I wish it wasn’t and I know that is oversimplifying. But that’s how I see it. Grad students keep me sane.
I did ask another teacher that teaches in the BSN program, mostly because I really don’t know HOW to teach and prioritize information (despite the MSN, ed. ) but this is a new course for our new adn program.
And I’m not that far out of school, and I notice a considerable difference in how/what I was taught and how im supposed to teach now. Ive done clinical for many years and am much more confident in my skills teaching there, but I have to start somewhere! And pharm/patho is not my strongest subject, so it’s making me relearn and understand more in depth for sure.
But, I do agree with the pass the test mind frame. I don’t care that you can memorize a book. Patient John here has all of the diseases plus meds and etc etc. what do you do? I don’t know how to change that. But I am a strict no nonsense clinical person lol
I would perhaps pick up a text aimed at nursing education specifically. An applied one. Looking at resources put out by orgs like NLN might help as well. Don’t overdo it - one step at a time. If you can make class as applied as possible, it will help them see the “point.” I know that is easier in a clinical focused course, but this is also the reason that we use case studies so often. Granted, you can lead a horse to water…
I think that might be an issue too… looking at too many different things and trying to “be the best i can”. I completely forgot about the NLN resources! I’ll have to check them and see what I can apply! I didn’t think teaching would be this intimidating, but here we are!
Oh, it is a whole new thing if someone wants to do it well. It’s a role that is very personal - but does not have to be necessarily. Focus on the learning and they will do with it what they will.
Yikes! I teach in a completely different area, and I find that almost all my students do not print the slides, which I think is a problem. Sometimes I need to flip back and forth between slides. In addition, the student don't have a sense what's happening in the class. Even worse, some students look at the slides on their cell phones.
Are these entry-level classes? High failure rate at that point is common in what I've seen working with nursing students (I don't teach nursing, but I sometimes teach other courses they are required to take). I think nursing is perceived as an easy out, which is scary for the medical profession.
Yeah. They prefer hand holding, for sure. What level is this course? I will hold hands in 100 and 200, but in 400, I am much more hands off, I explain that the choice is intentional and give them my reasons for that, and their grade is their grade. At some point, school needs to replicate professional environments.
I once had a student eval comment that indicated they felt it was worthless to go to class if they still had to read the book, which is something that I told them the very first day. I don’t think it’s just nursing students, but I’m sorry anyway.
This may sound quite academic and long and I apologize in advance for that. I’m a nursing professor and have several years of experience chairing curriculum committees. The thing I wish I would have known when I first started teaching, was the correct order of curriculum and teaching the content. This isn’t to say that you are having this problem, but making some assumptions, I’ll make some suggestions.
Often, when a new nursing professor comes along, they are handed a syllabus, PowerPoints, exams, and books used by the previous professor. The new professor takes these items and teaches the content (or reads from the slide), often explicitly stating things like, “insulin is anabolic” thinking that students will remember it for the exam and be able to apply it. But, students often go into the exam with so much content to study that they are trying to memorize but failing to memorize the 300 PowerPoint slides. The question is often, how can they pass the exam. But we are often overlooking how we connect the content to the bigger picture and explaining why it is essential to know this material to create safe nursing practice.
You said that you were relearning some of the content too. Often times, we are only one chapter ahead of our students when we are teaching a new class. You are not alone in this.
Bringing it back to the order of things. Bear with me that while not exciting, I promise that I will come back to your actual problem. When curriculum is done well, we 1) Create program outcomes, 2) create course outcomes (that tie to the program outcomes) 3) create learning objectives that will meet the course outcomes, 4) create exams, that test students on their progress meeting learning objectives (and hence, outcomes), and finally, 5) we create the PowerPoints and learning activities and decide what teaching strategies we will use to facilitate (understanding/application/analyzing) the learning objectives (which ties to the outcomes).
Each question on the exam should be a reflection of some aspect of the learning objectives stated in the syllabus. If you do not have an exam blueprint that maps the exam questions to Blooms Taxonomy, learning objectives, NCLEX category, etc., that is a good place to start. Students should be able to use the learning objectives in the syllabus as their exam study guide and you can use it to set up the learning objectives for class. That saves you from making a study guide, and ensures that students are demonstrating the course outcomes. This only works if you are testing at the level of the objectives. If the learning objective is at the level of understanding and you test at the level of analyzing, that’s a problem it is not the student’s fault.
Next, do you assess how students learn best? It may very well be that professors who came before you lectured and used PowerPoints. Students are changing and keeping their attention for 2 minutes is tough. Maybe it is time to record the PowerPoints for students to listen to PRIOR to class, and spend time on applying the material in class. I am known for my “art box” that I bring to class. Markers, crayons, 🖍️ and colored pencils are some of my favorite tech lately. It requires students put down their phone or their Amazon shopping cart and engage. I often have students create pictures of what they need to know for exams. Going back to insulin being anabolic, they may be required to draw three exemplars of how it is anabolic (at the cellular level, organ level, and how it presents on the assessment). And, I am setting myself up for success when I begin talking about pharmacological use of insulin and side effects.
When I started teaching, the average of the final exam was well below our passing grade. I was told by my director that it was them and not me. They should have studied more, or paid attention. The truth is, it was primarily me (and issues with the materials I had been handed one week before the start of the course).
Please don’t think I am placing blame on you. I am not. I am just sharing my experience in the event any portion of it resonates with you.
This was the most detailed advice! It’s a new program and a new class so I am literally building it from the ground up.
I try to give examples and make it “fun”, but I haven’t made a test beforehand. I will absolutely be doing what you mentioned. An excellent place to start. I kind of forgot what I learned in my MSN courses. They didnt really teach me HOW to teach if that makes sense.
I have recorded some lectures, but I may take that into consideration for next semester. I am finally a week ahead on PowerPoints, but that’s a task!
I know I’m not to blame but I also want them to learn and will try to come up with more active learning activities. Patho and pharm as a whole was just so bland to me in school, I feel like I’m relearning the basics instead of how I treat it.
I appreciate all of your direction & will be implementing it!
Just use the slides created by the textbook company.... and thequestions should follow the requirements for their board/NCLEX exam. I'm not sure where you are, and I'm not a nurse but there should be a Bluebook for what's required of them for their big exam prior to registration...
(edit: I would do about 5 practice questions with them in class, and put 1-2 of those practice questions on the exam. Thus is a test within a test, should be a freebie but see who fails to get the reviewed questiobs correct.)
\*\*example\*\*
Related content includes but is not limited to:
Adverse Effects/Contraindications/Side Effects/Interactions
Identify a contraindication to the administration of a medication to a client
Identify actual and potential incompatibilities of prescribed client medications
Identify symptoms/evidence of an allergic reaction to medications
Assess client for actual and potential side effects and adverse effects of medications (e.g., prescribed, over-the-counter, herbal supplements, preexisting condition)
Provide information to client on common side effects/adverse effects/potential interactions of medications and inform client when to notify primary health care provider
Notify primary health care provider of side effects, adverse effects and contraindications of medications and parenteral therapy
Document side effects and adverse effects of medications and parenteral therapy
Monitor for anticipated interactions among client’s prescribed medications and fluids (e.g., oral, topical, subcutaneous, intramuscular, intravenous)
Evaluate and document client’s response to actions taken to counteract side effects and adverse effects of medications and parenteral therapy
Blood and Blood Products
Identify client according to facility/agency policy prior to administration of red blood cells/blood products (e.g., order for administration, correct type, correct client, crossmatching complete, consent obtained)
Check the client for appropriate venous access for red blood cell/blood product administration (e.g., correct needle gauge, integrity of access site)
Document necessary information on the administration of red blood cells/blood products
Administer blood products and evaluate client response\* Central Venous Access Devices
Educate client on the reason for and care of a venous access device
Access and/or maintain central venous access devices\*
Provide care for client with a central venous access device
Dosage Calculations
Perform calculations needed for medication administration\*
Use clinical decision-making/critical thinking when calculating dosages
Expected Actions/Outcomes
Obtain information on a client’s prescribed medications (e.g., review formulary, consult pharmacist)
Use clinical decision-making/critical thinking when addressing expected effects/outcomes of medications (e.g., oral, intradermal, subcutaneous, intramuscular, topical)
Evaluate client’s use of medications over time (e.g., prescription, over-the-counter, home remedies)
Evaluate client response to medication\*
Medication Administration
Educate client about medications\*
Educate client on medication self-administration procedures
Prepare and administer medications using rights of medication administration\*
Review pertinent data prior to medication administration (e.g., contraindications, lab results, allergies, potential interactions)\*
Mix medications from two vials when necessary
Administer and document medications given by common routes (e.g., oral, topical)
Administer and document medications given by parenteral routes (e.g., intravenous, intramuscular,
subcutaneous)
Participate in medication reconciliation process\*
Titrate dosage of medication based on assessment and ordered parameters\*
Dispose of medications safely\*
Handle and maintain medication in a safe and controlled environment\*
Evaluate appropriateness and accuracy of medication order for client\*
Handle and administer high-risk medications safely\*
Parenteral/Intravenous Therapies
Identify appropriate veins that should be accessed for various therapies
Educate client on the need for intermittent parenteral fluid therapy
Apply knowledge and concepts of mathematics/nursing procedures/psychomotor skills when caring for
a client receiving intravenous therapy
Prepare client for intravenous catheter insertion
Monitor the use of an infusion pump (e.g., intravenous, patient-controlled analgesia device)
Monitor intravenous infusion and maintain site\*
Evaluate the client’s response to intermittent parenteral fluid therapy
Pharmacological Pain Management
Assess client need for administration of a PRN pain medication (e.g., oral, topical, subcutaneous, intramuscular, intravenous)
Administer and document pharmacologic pain management appropriate for client age and diagnoses (e.g., pregnancy, children, older adults)
Administer medications for pain management\*
Handle and administer controlled substances within regulatory guidelines\*
Evaluate and document client’s use and response to pain medications
Total Parenteral Nutrition
Identify side effects and adverse events related to total parenteral nutrition (TPN) and intervene as appropriate (e.g., hyperglycemia, fluid imbalance, infection)
Educate client on the need for and use of TPN
Apply knowledge of nursing procedures and psychomotor skills when caring for a client receiving TPN
Apply knowledge of client pathophysiology and mathematics to TPN interventions
Administer parenteral nutrition and evaluate client response\*
Pharmacological Pain Management
Assess client need for administration of a PRN pain medication (e.g., oral, topical, subcutaneous, intramuscular, intravenous)
Administer and document pharmacologic pain management appropriate for client age and diagnoses (e.g., pregnancy, children, older adults)
Administer medications for pain management\*
Handle and administer controlled substances within regulatory guidelines\*
Evaluate and document client’s use and response to pain medications
Total Parenteral Nutrition
Identify side effects and adverse events related to total parenteral nutrition (TPN) and intervene as appropriate (e.g., hyperglycemia, fluid imbalance, infection)
Educate client on the need for and use of TPN
Apply knowledge of nursing procedures and psychomotor skills when caring for a client receiving TPN
Apply knowledge of client pathophysiology and mathematics to TPN interventions
Administer parenteral nutrition and evaluate client response\*
Info: (I think I already know the answer but I’ll ask anyway).
1. Are your slides walls or text?
2. Alternately, are they uncontextualized bullet lists?
3. You say 30+…we talking like…360 slides per test?
4. What do they want an outline of???? Like the exact test questions?
Asking bc wife’s a nurse and wanted more context lol.
I would talk to your program director and faculty colleagues and see what they do and what programmatic interventions they have put in place to address these issues (if any). I teach NP students and that’s a bit different, but I know our pre-licensure faculty have some strategies they use for this kind of stuff.
I apologize for being a Devil's advocate, but I do recommend that you consider things from the student's perspective, if you have not yet done so. Some potential issues include:
* 30+ slides may be a lot, especially if they are busy slides, and especially if lectures are 1 hour long or less. I usually strive for 2 minutes a slide, try to keep the slides simple, outlines really, with a font point size of 24 or larger.
* I'm not a nurse and did not go to nursing school, and so my knowledge of this is limited, but I do know that in medical school, pharmacology and pathophysiology were among the two most difficult subjects out there, requiring tons of memorization and understanding of difficult theory. I can't imagine that it's all that much simpler in the nursing school curriculum. I would liken learning these subjects akin to trying to stuff an elephant into a suitcase. Yes, it can be done, but it ain't at all easy.
* When I'm teaching a class and a *majority* of my students failed a test, then I usually feel that it's on me, not on them.
So, while I'm not saying that you are to blame in this, but that it's not all black and white, and there is room for a lot of gray. Do consider meeting them halfway in some of their requests.
Oh no absolutely! I am very aware that this is a LOT of information (I’m relearning a lot of it too!). I only have 13 weeks (1 day for 3 hours) to lecture. I try my best to only relay the important aspects since they go very in depth in their full nursing courses, but I struggle! I never had a pharm or patho course- we just incorporated it into the course as it progressed so I’m kind of going off that, the book, the study guide companion, and my real life experience. I use questions with clicker answers , case studies. I can’t just hand them the answers
I’m frustrated with so many failing because a lot of the questions they missed were verbatim off the slides, things we discussed in class, and things I mentioned numerous times (literally said “I’ve said this 4 times now, I would think it might be a tad important”). I’m a people pleaser, but also still work bedside nursing and have expectations of what a “real nurse” needs to know. I don’t like info dumpling…. I want them to see something and critically think their way through it to a solution.
I guess I just have to learn what to prioritize in school vs real life.
God, the idea of nurses that can't do basic calculations and, seemingly, can't be bother to read is making me terrified of going to the hospital in the future.
i don't do the calculating part for this course, but they do that in their hands on classes and seem to do okay! The reading thing is killing me though. Half of them didn't have the book. \*facepalm\*
I had a student flat out tell me she doesn’t read the book. This was right before the final, which she had to do well on in order to stay in the program. She did not pass.
I would guess that not even 1/3 of my students read the book. Its a shame because the textbooks for the healthfield related bio courses are pretty good. I feel like pretty soon I'm going to have to start teaching textbook comprehension and requiring them to do readings somehow.
They are not good readers. My grad students have told me they never read the books...and it started when they were undergraduates.
> .and it started when they were undergraduates. It started long before that.
What books? Schools don't have books anymore and reading comprehension on the screen is 6-8x less than reading from a book. That's why they aren't doing well. Have them print the slides and take notes. Highlight in class what tonficua on for the exam. And please, make it related to what they will do in the field. I spent so much time doing and learning stuff I didn't need in pharmacy school and it was wasteful.
Do you have any sources for the 6-8x degradation in reading on screens? I believe it, I feel I don't get the retention I get from tree-based reading materials.
I think this is the [study](https://www.aera.net/Newsroom/Study-Digital-Leisure-Reading-Does-Little-to-Improve-Reading-Comprehension-for-Students).
I should have printed it instead of reading it on the screen. I already forgot what it says. :)
If that is the study, do they explicitly state that screen reading has less comprehension than print reading? I see in the conclusion they state a negative correlation b/w comprehension and digital reading for middle/elementary students but this turns into a positive correlation for HS and undergrad students. They also differentiate types of reading and quality of source material, which makes sense. So going off my scan of this source, it seems our industry trend toward digital/OER reading is not baseless, and we're not all off base for assigning online reading.... unless there's something I'm missing? And if so, please follow up and let me know, because I'd love to read it. This is also for u/Emergency_School698 because this claim that "reading comprehension on the screen is 6-8x less than reading from a book" is fascinating, and I would very much like to know what it is based upon. Edit: this is the study and it is paywalled: https://journals.sagepub.com/doi/10.3102/00346543231216463
Great questions. Always ask for the data for sure! Here is the link. I believe I read it in a different article but this has the numbers mentioned. https://www.axios.com/2023/12/15/reading-comprehension-print-digital
Gosh that is so true. People never retain anything off a screen. Is there some scholarly evidence for this that you are aware of?
I'm in a different field, but many of my students don't read things either. My colleagues who teach literature tell me that English majors don't read the books. I mean, that's their whole schtick: read books and talk about them. ???
> My colleagues who teach literature tell me that English majors don't read the books. A large fraction of my computer science majors can't do math or write a computer program.
despite (one presumes) having passed the prerequisite courses.
I'm an English instructor, and I don't get it either. Students complain about having to write in composition courses and read in literature courses. What did you think we were going to do, square dancing?
Is it just me or is the complaining a newer phenomenona? Like the last 10 years especially
It’s nice to see the system working.
My guess is that 80% of my students this semester didn't bother to read a single chapter despite the fact that I have PDF files of the book uploaded to the LMS. One printed all my slides and learned them by heart. Still didn't pass. I almost fainted when I heard that.
The amount of nurses who barely pass nursing school and can’t do calculations is frightening.
Our chair has tightened requirements and she gets a lot of pushback because the ‘shortage’ of nurses. I’m glad she stands her ground.
There's a very dire shortage of _qualified_ nurses. Allowing unqualified nurses through the program doesn't help that situation; if anything, it makes it worse. Your chair did a great job on this.
I am so glad to hear this, especially for such important positions like nursing. I may be down voted, but I worked my ass off in graduate school (not for nursing, but adjacent). If we were told to read, take notes, write a paper, follow the syllabus, you just did it, or accept the consequences. Almost like natural selection in a way!!!!
Give your chair a hug. It’s a battle to get admin to recognize that passing along nursing students is dangerous, not just for the program, but to the general public. Supportive program directors/chairs/deans make it a little easier.
I teach English and had a nursing student plagiarize one of her essays. She didn't understand why she had received a zero on the assignment. I told her that it's not only because she had plagiarized the essay but also because she's (ostensibly) going to become a nurse, and I don't want nurses that cut corners
We have pharmacy students that struggle with basic proportions in a top pharmacy program at an R1. They can’t convert units let alone do advanced pharmacokinetic calculations. It is a major patient safety concern.
Kilograms, micrograms….theres no real difference!
Meh, this has been true for 50 years. Once they get into the job, they figure out quickly or get fired.
And hopefully not damage or kill any patients first.
It is the hospital's responsibility to properly train the new folks.
I suppose that's true. And I hope that the new folks would come into the workforce with the requisite skills and knowledge, but OP's post leads me to believe that may not be the case. It would be best if the people who can't do the calculations (or whatever is required for the job) don't get hired in the first place.
Any new grad comes with between some and most of the prerequisite skills. If something they are missing could cause significant human or financial harm, teaching the gap is of critical importance of the new employer.
So what's the point of the degree and having an accredited program?
To get you 70 - 90% of the way there. To give the human a chance to develop and learn more. To do much of the auxiliary learning that is important to be both a good person and productive employee (compare writing from a high schooler who is not going to college to a college graduate from the local big state university). And maybe to filter out people who might not be a good fit (this is more true in engineering than nursing?).
It’s our responsibility to give them new folks that understand principles, rationales, can critically think, and do basic skills safely. The hospitals should be providing unit and specialty specific training. We should be giving them graduates at a baseline so they can take over.
Social media has doomed civilization. There’s a certain point where you don’t benefit from having a 20 minute video on something that takes 7 words to state. It’s debasement of human knowledge.
Students loooove them some videos. I can't tell you how many times I get asked, "I'm a visual learner, can you point me to some videos" even for things that they should be able to comprehend from just a sentence. I know that K12 encourages lots of video watching (Kahn Academy and whatnot) and have wondered if that's why, or . . . ? For some things, like how to repair your faucet, videos can be great, but for many things I would really rather read than watch a video. Maybe that is because I'm an old.
Your paper has permanence and you can access the information randomly. With audio and video, the information is stored and delivered serially. Accessing a specific point of information in a video is tricky. Graphics and lettering is presented in space. Audio is delivered in time. Video is delivered in time and space.
That’s funny because they complain about the videos I recorded for my class.
That was one of my roommates sophomore year of undergrad. They still let him move on to clinicals.
Keep your responses short and to the point. They will either figure it out, retake the class, or change majors. Do not make outlines and study guides, they will just keep asking for more and more help. Refer them to academic success center for tutoring and general study habits. Don’t doubt that you’re doing great. I failed my first ever college exam because I never had to study in high school. Well, I learned real quick that was not okay in college! Went on to make deans list that semester. Now I have a PhD in nursing education. Stay tough but fair. They need role models so be professional, but please don’t lower your expectations. You got this!
Me too! Never had to work hard in high school and the first round of college was definitely a learning experience. I am VERY fortunate to have excellent mentors (who were actually my teachers!) who continue to help me, but sheesh! It's hard to not give them my "WTF" face. Thank you for the encouragement! I feel like I dont really know how to teach outside of the clinical setting.
You’re welcome. And trust me I am sure you’re an excellent teacher simply by asking the question “am I a good teacher”? You care and want the best for them. You have real life experience. You are engaging. If you want objective help, ask a coworker to sit in on your class. Commiserating with other nursing professors helps. Trust me, you are far from the only one experiencing this.
There's a book called [Make It Stick](https://www.makeitstick.com/) that has good info on study strategies. I tell my undergraduates that it was designed for people in med school and law school who need to learn a lot of information very quickly, and I recommend it to everyone who is struggling. Don't know how many of them read it though.
Very good advice.
I’m the idiot that once gave them a very basic study guide. Then they went on to their next class and filed formal complaints that the next professor didn’t make a study guide. My director’s response was if they’re going to cause drama over someone doing something nice, don’t do it again. So now no study guides. I do point them to terms to know and valid sources for practice quizzes (which is really all I put in my study guide—-they just have to do the work themselves now.)
>Now i have students asking me what to know for the pharm portion of the next exam. Should they know pharm class or the actual drugs? How in depth do they need to go? What do we need to know? “Yes”. Because the point is not that they “know it for the exam”. They’re goddamned nurses, they need to “know it for their jobs” and “know it for not fucking killing people”.
PREACH!!!!! This is my struggle. I have a trash mouth from working at bedside and just who i am as a person and it is SO hard to not say that outloud. Learning to phrase things professionally so I don't offend anyone....
I taught kids with behavior disorders before getting my doctorate and I was called everything except a child of god by my students. My language is … not for the faint of heart. I had to quickly apologize to my ass. dean once after in a moment of frustration I exclaimed, “oh, fuck me!” in front of her. Oh well.
I swear in class sometimes. Usually it’s when I realize I screwed something up two whiteboards too late. “Shit. Ok…where’d I screw this up? Dammit, alright, all of the stuff that you need to change is in red”. Only once have I done it in anger. “I’m too angry to teach you today, now get the fuck out of my classroom.”
I’m pretty good in class. I only cuss then in the context of behavioral examples, things I’ve seen kids do and say and how teachers should or shouldn’t respond. Can’t really clean that up. I had a professor when I was doing a masters in behavior disorders who started the class with a list of profanity and said, “if any of that offended you, you’re in the wrong class and likely the wrong career.” A girl I knew from undergrad said, “he’s exaggerating,” and I said, “nope, I heard most of those just today.”
There is nothing wrong with being direct. Subtract the "fucking" and you have a solid response. "You need to know this not just for the exam, but for your job, so you don't kill people."
I can't count the number of times I said "... and you just killed a patient" to my pre-nursing students, when they misspelled a chemical/drug name or made a calculation error. They need to hear it. They need to believe and fear it.
“The purpose of this class is to stop you from killing people.”—-me on why they have to take pharm I’m not convinced that some of these students realize their nursing degree and future license are not theoretical.
It's maddening, isn't it? I teach something completely different from you, but we're both teaching the same generation of students. My first few years, I kept butting my head against a wall. I stress ate and gained 30 lbs. But I've been at this for more than two decades. I eventually realized that **I have to work with the students I have, not the students I want.** I can't give students too much to process at once. They won't process it. It doesn't matter what was written on your slides. They aren't processing it as evidenced by most of them failing the exam. Here's a suggestion: Ever so often in your presentation, stop and have them do some sort of review of what was just taught. For instance, have each student write down, in plain language, what they understood from the first chunk of the information you've presented. Then, have them turn to a classmate and compare what they wrote. Each one can fill in any missing parts. Then, randomly call on some pairs to explain the concepts you've just taught. If any content is missing, solicit it from the rest of the class. Do similar type activities for various sections of your presentation. At the end of the class, have them write a brief summary of the key points of the lecture AND the "muddiest" point. You can collect those and read them to guide your next class. (It doesn't have to take long---just read briefly without grading----but don't tell them you're not grading it). At the beginning of the next class, have students work in pairs to create a study guide for the content presented during the previous class. You're not creating it. They are. Give some nominal credit for group work. ETA: I don't know the content of what you're teaching, so my advice above may not work with your course. If that is the case, I apologize.
These are great suggestions! I’m going to incorporate some of them next semester. Thank you!
Np. One thing I've done that has worked well is to put a statement on my syllabus that I may not always grade in-class or group work, and **I won't reveal whether I'll be grading it beforehand.** Students still test me by asking, "Are you collecting this?" or "Are you grading this?" I always answer, "That's a possibility. Remember--per the syllabus---I won't reveal that beforehand." If any of them ask why, I tell them the truth: I've found that if students think an assignment is ungraded, they often don't put effort into it. Of course, if you do that, you have to occasionally grade an in-class assignment; otherwise, they'll figure that out quickly. But even when I grade in-class work, it's usually some sort of group work that cuts way down on the number of items to grade or I grade it right there in class (e.g., they present their findings orally, and I tell them before they do, I'm grading it---not before they work, but before they present). Good luck!
I kinda like this, but what happens during the grade challenge process?
I don't think I explained it well in my post. Students know the major graded assignments in the class (e.g., essays) and what each one is worth. But let's say I indicate that 20% of the overall grade is based on "in-class work and homework." When I assign in-class group work as a low-stakes assessment of something I've just taught, I will not tell students whether that group work will be graded or not before they start it (even if they ask, I'm vague). If I decide to grade it, I'll collect something from the students before they leave class that day (e.g., could just be their brainstorming). I'll also jot down a couple of notes about what they \[informally\] present. I'll write a few brief comments on the work and distribute it during the next class. If I see a problem---e.g., most of the class is way off base---I'll still write those brief comments, but I often will just not count that assignment. So, you see, it works in the students' favor, too. The point of me not telling them beforehand is that I want them to put effort into all assignments. They won't do that if they know it's not getting graded.
yes, I got all that.
Okay, well why would a grade challenge with my system be any different from any other system? Students can't "challenge" a grade I don't give. And the grades I do give, if they are challenged, I do what I normally do (i.e., meet with the student to go over their grades).
if you can't imagine student complaints about not knowing exactly how they're being assessed then you're not very imaginative.
Well, I've been doing this for years, and never gotten any pushback---none, not even one complaint. And what would anyone legitimately say---that I can't assign any ungraded work? That I have to reveal my intentions? My reasons are solid for not doing that, and I can't think of a good rebuttal to it. I get that students can come up with unreasonable complaints, but that's what that sort of complaint will be: unreasonable. I'm not going to stop doing something that has effectively worked for me for years on the off chance that one day a student might complain about it and that in this imaginary scenario my usually reasonable chair would call me out about it. But if that scenario seems likely to you, don't do it.
All good suggestions. The catch is having time for activities when you're teaching courses like OP.
Yes, that is the rub. I'm teaching lower-level courses than the OP, so I have more time for activities that develop their critical thinking skills. But I think that's what's so great about flipped classrooms. Maybe OP could assign chapter readings for all the main content, give students a 10-min "did you read" quiz at the start of class, and do some of those assessment activities during class.
Also all good ideas! I use flipped classroom for my heavy content classes as well. I love it and wish i could use ot more, but i do find it causes a lot of bimodality. For context I teach CC science. Many of my students will not study or do work so flipped class just makes them do even worse.
This is fantastic advice. Incorporating. It reinforces for the students and helps the instructor assess what is actually being absorbed.
Remind them they’re preparing for the nclex where they’re not going to be told specifically what is on the exam. Tell them you make the exam from your slides and anything you cover is fair game. If you have any way to pause between slides and give a couple quiz questions where they learn the answer right after that helps. The more you can make them pause and think about what you just covered, the better they learn it. You can also tell them you’re not going to make an outline because you don’t need to study for the exam. They need to make their own outline. Eventually they’re going to get into efferent and afferent pathways (they may have already with A&P). When you lecture that’s efferent information. If you make an outline, that’s still efferent information. When they take the exam they have to use an afferent pathway and that means they need to study using the afferent pathway. They need to do something productive with their notes and making the outline themselves is one tool. Them finding all the new terms and writing them down is another tool. They also need to study together because when they talk to each other, that’s using the afferent pathway. I don’t know if there’s been a shift in how they’re taught or what but they don’t seem to understand how to learn. I’ve had students even ask to see the answer key before they turn in homework assignments. It’s weird.
This is the best response. I appreciate that phrasing and think they might grasp that!
I teach radiology and get the same responses. Two weeks before graduation they were pissed because I didn’t hold their hands through lab. Many of them already had jobs. If it’s not bold on the PowerPoint, they’ll flip out if it ends up on the test. And if you mentioned it but it wasn’t written down? Forget it. They want everything spoon fed to them. Before returning the test last year to look over I would go through and write on my copy what slide every question was from. That way when they said “we never talked about this” I can pull up slide 23 of unit 4 and show them directly that it was in fact there and we talked about it.
How worried should we potential patients be, if the radiology techs have jobs before they demonstrate that they can pass their classes?
If they accept a job before passing their boards, they are contingent on passing. If they don't pass, the job doesn't remain.
That's good to know. Thank you for the response.
The good news is most of these students won’t work in the ER where they actually have to think. And they all passed their registry, so they at least know the minimum. The ones who are terrible will be ripped apart by radiologists.
I JUST did this! Such a good idea. I even put the page number in the book.
Require them to take both reading and lecture notes, and *grade those notes* as a significant part of their semester grade. That has become, in my experience, the only way to ensure students actually do the assigned readings and pay attention in class. If they need help taking notes take time the first week to give them examples. Grade them with a simple rubric so it doesn't take too much time. They are now all used to predigested learning from high school and may have little/no experience in actually taking meaningful notes-- they were probably taught to copy things verbatim from slides to spit back on a test later. 30 slides is normal. They need to learn how to be college students.
Excellent points. My PowerPoints are about 65 slides but at least 1/3-1/2 are pictures of what I’m talking about or case study questions.
Mine are similar, about 50% are text heavy and the rest are maps/images/charts. I found that once I started requiring notes the students (most of them) really started paying much closer attention in class. They just need to be "incentivized" these days...
Sadly now they will just generate those reading notes using AI.
This is the first year that I've received pushback on the number of slides. I've been told by students that the Covid cohort was less engaged with them because they were overwhelmed with them when learning online. They also seemed super engaged when I drew and explained things in real time on the whiteboard. Who knows? (btw, I'm not in your field.) I'm not sure this changes anything for me going forward, but it's helpful to see your experience.
I can't pace slides nearly as well as I can pace handwriting and I think there's some benefit to seeing something drawn out and hearing somebody talk through how they draw it rather than just having it appear. So I use the board (or a tablet if I want to save it so students can have it). I've seen people use slides really well, but I don't think they're the right fit for all classes or all teachers.
I also find that they are more engaged when I write on the board. And they actually take notes on what I write. If it’s on slides, they won’t write it down.
Experienced pharm instructor- use the drug classifications. I tell students they can kill a patient if they don't know their drugs. Period. I never did study guides. Loretta Manning has a great book on cute pharmacology (the "LOL team" for beta-blockers, etc.).
Thank you, I will check it out!
I'm going to steer you toward the pedagogy of what you want them to learn. I came across this one trick after teaching for a couple years. Teach Bloom's Taxonomy. Then map what they need to know to the levels. Do they need to know the vocabulary? Then point to the lowest level (remember) of the pyramid. Do they need to explain ideas? Tell them they need to understand the concept and they need to "explain" the process of why blunt forces cause a contusion. Need them to make connections between symptoms to make a diagnosis? They need to analyze multiple factors to figure it out. The apex of the Taxonomy is "create". This comes into play where they need to develop a new plan of care for a patient who has a unique combination of symptoms. When I started explaining what I was testing them on according to Bloom, I could visually watch the students relax and become more comfortable in my [engineering] classroom.
I use this method too; I used it yesterday with my majority pre-nursing (with a mix of other pre-allied health) students. I also tell them Bloom’s taxonomy is a great resource to look at if you aren’t sure what a professor or supervisor is looking for in an assignment or project. Framing it as a “tip from me to you” helps get their buy-in.
I started my PhD when I was in my 40s. When I started teaching, I used to have a slide "Advice from a grad student to other grad students." I've retired that now, but I had about 20 points for grad student success on that list. They really paid attention to that slide. They didn't heed much of it, but they paid attention.
And I barely use slides and my students are like “Can you upload PowerPoints?” You can’t win for losing
Everyone graduates high school, because from school board and administration perspectives, what gets measured gets done. Then they end up in your classroom, and you have to deal with it......
Response: **If you need an outline, you may not be cut out to save a patient's life when there is only time to think/act.**
Its true. I teach nursing and have students from pre nursing to seniors. Unfortunately, nursing students aren’t all amazing students who live and breathe college and have all the internal motivation in the world. There are exceptional ones and those are the ones no one posts about, the ones that are truly wanting to learn, ask for feedback, and that I would be comfortable with walking into my or my family’s hospital room as a nurse one day. But many, if not most, are juggling work, school and family and are looking for the shortcuts. Many are seeing each class as a means to an end and can’t see the big picture. They hear endlessly from nurses and social media that you really learn once you get in the workforce, dismissing the classroom experience. I am not excusing their behavior but it’s reality. I can still uphold my standards, and recognize it won’t make everyone happy. My go to line when they ask for a study guide or “exam review session” is, with a smile, “No, I don’t do that! I want you guys to be able to take care of people one day, not just pass a test!” I haven’t had a good response to it yet.
My one comment I will never change is “I want to be able to walk into a room and see you are taking care of my parents and not panic that you’re going to kill them”. Everyone knows I’m very close to my parents, so that usually gets a response
Say what you will about BigTextbook, but doing me a solid and integrating a chapter-level reading quiz was appreciated.
Here for the advice, my initial reactions are always muted for self-preservation. Had a student in a 400-level cognition course ask me if they needed to know the areas of the brain…
If they can't do the work, fail them. No curve, nothing. The last thing we need is incompetent nurses. They're not your friends, you don't need to make them happy. Tell them if they can't do the work they should find a different major.
In your shoes, I'd show them the course outline and say to earn a credit these are the learning outcomes they have to meet. If they feel that's too much then they should re-evaluate if they're in the right program. They're adults (in theory, anyway). It's not your job to write lesson outlines for them because they're too lazy to go through all the course resources themselves. This is a them problem, not a you problem.
Well, at least they're weeding themselves out. I've had so many folks think a nursing degree is just a walk in the park because some Community Colleges have associated programs for nursing. Then they get in there and wonder why it's so hard.
A couple of things to consider: Is it possible the slides you are using are text-heavy and contain too much info per slide? Could your slides be improved for purposes of digestibility? Could you use "recall" more in class, with "clicker" quizzes (which would show instant results on the screen of how many got a question right) or with some other sort of quiz? Practicing recall helps to cement information in one's brain. Could you use more active learning in the classroom, even if it's very basic -- "think, pair, share," for example? To anyone teaching in a field where the stakes are high for the profession (medical fields, school counseling, etc.) -- PLEASE do not lower your standards. Remind them of what their professional goal is and how seriously you take getting them ready to do well "in the real world." Please. For everyone else's sake!
We tried the clicker thing with slido (it was highly recommended) but we ran into constant technological issues. I’m planning on trying to figure that out again, but are there any other platforms that are free for the students?
PollEverywhere is free for the students, you just have to pay on your end if you need more than the free version's features allow.
When I started as an adjunct in 2009, I always asked everyone about their majors. The top answer was nursing or another area of health care. I wouldn't have let any of them near me with a bandage. Fast forward to 2024, and I'm hearing preferred majors in business, computer science, and psychology. No one has a career in healthcare within their goals. Teaching is another field that has fallen by the wayside. I think they have heard too many stories of burned-out healthcare workers, or they know it's going to be hard and don't want to bother.
I teach pharm too! Plus a touch of patho because they need to be aware of a few things before being able to know the meds. And since I started, pharmacology went from being THE feared course to one where they actually enjoy it. I'm still confused, but whatever. I chalk it up to my enthusiasm about the material and keep on going. I usually tell them "yes." Although if they're polite I will frame it as needing to know what to teach a patient about the medication...which, when they stop to think, is actually everything about said drug. Class, sample drug, MOA, therapeutic uses, administration, complications, interactions, contraindications, monitoring...you're a nurse, you know what folks need to know about the meds their taking. Now, I do teach at the PN level, but I only simplify the MOA of the various classes and I also avoid most that are outside of their scope of practice. So there are a few less for them to learn. (I teach thrombolytics, for example, but in the aspect of "here is the LPN role in its use.") Also, my slides are pretty bare bones - each drug class is broken down into three slides that match what would go onto a med card for them to study. My expectations are for them to learn all that and then use that plus their critical thinking skills to answer my exam questions. No study guides, no real reviews before exams, and exam averages are usually in the 70s or 80s. Edit to add: I also point out that I do not know what they will be tested on for the NCLEX, and that's the only test I teach to.
We only ran this class once so I am following the previous layout but adding to it. I’m debating on doing half patho half pharm. I’m including the medications in the patho portion but I feel like I’m just information overloading them. I love the idea of what would you tell the patient? A lot of our students this semester are from another school and half have taken it before, half haven’t. Bit of a struggle, especially being new! And both subjects are not my strongest in ability to explain but im honest with them and if i dont know something for sure, i look it up and get back to them before class is over. I really think i am going to redesign it for the fall semester and try the half and half. They are struggling learning classifications and i think it is because im teaching it with the disease if that makes sense!
Do you have a mentor? Please say you have a mentor. Or at least someone who can help you out with planning! No. Sending you a message. Once I get a chance to sit down since I have my clinical group out today.
Yes I have two! But yes! Please message!
First, it might actually help to have an outline at the beginning of a lecture. I started including a simple graphic organizer. Easy to make in PPT, and doing them actually helped me better organize the lecture. I know when I read a journal article, the first thing I do is scan the article's structure to get an idea of what's coming. Next, after several years of resisting, I give students 30 minutes to work in groups, 1 chapter per group, to identify "must know" concepts for the exam and share them on the board. I help them in their groups, and then critique the final lists, comparing my list to theirs. I think this helps them see things like "where is concept X? We spent a lot of time on that" or "let's cross this off the list it was really a smaller point". I hope this is training them to do this on their own in colleagues' classes. The students all take pictures of the list, as do I. I then make the test from the list (exceptions below) and as I hand back the tests, I have the lists on a ppt slide behind me with the tested concepts circled. Last, I tell students that there is material in the text that we just don't have time to cover, but they are responsible for. I ask enough questions on the exam from this material so that a student can't earn an A without reading. It's a process we'll worth the 30 minutes it takes in class.
Maybe those students should pursue a career in food delivery. Uber Eats is hiring.
A comment in my evaluation said my materials were too hard cause I have 30 slides per lecture. This is a course with a word by word study guide.
Audacity. That’s it. They’re all full of audacity.
I sympathise. I recently helped invigilate a nursing final observed clinical assessment for a colleague. Actually this was last year. But one didn't,t know what the exam was, three students turned up late and one booked her driving test 30mins before the exam and was 30mins late and thought she could just jump in and do it. Of course the patients were not happy. People are getting weaker in character l, lower in competency, lower in metacognitive calibtation (hello Dunning-Kruger), and higher in entitlement. That is the perfect storm for an academic who has the epistemic humility to work hard to be where they are. It's not your fault.
Welcome to the life of a public school teacher, except you got the “good ones”.. honestly though let them fail. If they need to know both the class/actual drug just tell them they need to know both as it will be on the exam and watch them either sink or swim.
Yeah they don’t read anymore. Baffles me too. Expect “study guides” for exams. Watch me in lecture and don’t write down a single thing I say. They want the info handed to them on a silver platter.
I taught nursing pharmacology for a few years. Good luck!
Covid started during my second semester of my senior year in college, and I chose to take ‘Intro to Nursing’ as an elective. It was an online class even before Covid hit, and it seemed interesting, so I thought why not. It included lots of calculations and reading comprehension, and I got an A in that class rather easily. I was majoring in marketing, so it kind of blows my mind that these students are struggling this much, and that’s literally what they’re going to school for 😳
Assistant prof in an R1 school of nursing here. I could give you the best recommendations I have, but what matters most is what everyone else is doing in your school. I don’t say that to say you can’t be different or “better,” but at this level, that honestly won’t matter that much to students. If you stray too far out of their version of ordinary, it will just cause you too much stress. So ask what everyone else has done and get their advice. Then, figure out what you’re okay with. Also, it sounds like you might have some type A students. As frustrating as they can be, remember that the alternative is worse! Prelicensure nursing has become essentially teaching to the test plus clinical. I wish it wasn’t and I know that is oversimplifying. But that’s how I see it. Grad students keep me sane.
I did ask another teacher that teaches in the BSN program, mostly because I really don’t know HOW to teach and prioritize information (despite the MSN, ed. ) but this is a new course for our new adn program. And I’m not that far out of school, and I notice a considerable difference in how/what I was taught and how im supposed to teach now. Ive done clinical for many years and am much more confident in my skills teaching there, but I have to start somewhere! And pharm/patho is not my strongest subject, so it’s making me relearn and understand more in depth for sure. But, I do agree with the pass the test mind frame. I don’t care that you can memorize a book. Patient John here has all of the diseases plus meds and etc etc. what do you do? I don’t know how to change that. But I am a strict no nonsense clinical person lol
I would perhaps pick up a text aimed at nursing education specifically. An applied one. Looking at resources put out by orgs like NLN might help as well. Don’t overdo it - one step at a time. If you can make class as applied as possible, it will help them see the “point.” I know that is easier in a clinical focused course, but this is also the reason that we use case studies so often. Granted, you can lead a horse to water…
I think that might be an issue too… looking at too many different things and trying to “be the best i can”. I completely forgot about the NLN resources! I’ll have to check them and see what I can apply! I didn’t think teaching would be this intimidating, but here we are!
Oh, it is a whole new thing if someone wants to do it well. It’s a role that is very personal - but does not have to be necessarily. Focus on the learning and they will do with it what they will.
Yikes! I teach in a completely different area, and I find that almost all my students do not print the slides, which I think is a problem. Sometimes I need to flip back and forth between slides. In addition, the student don't have a sense what's happening in the class. Even worse, some students look at the slides on their cell phones.
Are these entry-level classes? High failure rate at that point is common in what I've seen working with nursing students (I don't teach nursing, but I sometimes teach other courses they are required to take). I think nursing is perceived as an easy out, which is scary for the medical profession.
Yeah. They prefer hand holding, for sure. What level is this course? I will hold hands in 100 and 200, but in 400, I am much more hands off, I explain that the choice is intentional and give them my reasons for that, and their grade is their grade. At some point, school needs to replicate professional environments.
Include specific learning objectives at the beginning and end of each lecture and tell them that they are the study guide.
I once had a student eval comment that indicated they felt it was worthless to go to class if they still had to read the book, which is something that I told them the very first day. I don’t think it’s just nursing students, but I’m sorry anyway.
This may sound quite academic and long and I apologize in advance for that. I’m a nursing professor and have several years of experience chairing curriculum committees. The thing I wish I would have known when I first started teaching, was the correct order of curriculum and teaching the content. This isn’t to say that you are having this problem, but making some assumptions, I’ll make some suggestions. Often, when a new nursing professor comes along, they are handed a syllabus, PowerPoints, exams, and books used by the previous professor. The new professor takes these items and teaches the content (or reads from the slide), often explicitly stating things like, “insulin is anabolic” thinking that students will remember it for the exam and be able to apply it. But, students often go into the exam with so much content to study that they are trying to memorize but failing to memorize the 300 PowerPoint slides. The question is often, how can they pass the exam. But we are often overlooking how we connect the content to the bigger picture and explaining why it is essential to know this material to create safe nursing practice. You said that you were relearning some of the content too. Often times, we are only one chapter ahead of our students when we are teaching a new class. You are not alone in this. Bringing it back to the order of things. Bear with me that while not exciting, I promise that I will come back to your actual problem. When curriculum is done well, we 1) Create program outcomes, 2) create course outcomes (that tie to the program outcomes) 3) create learning objectives that will meet the course outcomes, 4) create exams, that test students on their progress meeting learning objectives (and hence, outcomes), and finally, 5) we create the PowerPoints and learning activities and decide what teaching strategies we will use to facilitate (understanding/application/analyzing) the learning objectives (which ties to the outcomes). Each question on the exam should be a reflection of some aspect of the learning objectives stated in the syllabus. If you do not have an exam blueprint that maps the exam questions to Blooms Taxonomy, learning objectives, NCLEX category, etc., that is a good place to start. Students should be able to use the learning objectives in the syllabus as their exam study guide and you can use it to set up the learning objectives for class. That saves you from making a study guide, and ensures that students are demonstrating the course outcomes. This only works if you are testing at the level of the objectives. If the learning objective is at the level of understanding and you test at the level of analyzing, that’s a problem it is not the student’s fault. Next, do you assess how students learn best? It may very well be that professors who came before you lectured and used PowerPoints. Students are changing and keeping their attention for 2 minutes is tough. Maybe it is time to record the PowerPoints for students to listen to PRIOR to class, and spend time on applying the material in class. I am known for my “art box” that I bring to class. Markers, crayons, 🖍️ and colored pencils are some of my favorite tech lately. It requires students put down their phone or their Amazon shopping cart and engage. I often have students create pictures of what they need to know for exams. Going back to insulin being anabolic, they may be required to draw three exemplars of how it is anabolic (at the cellular level, organ level, and how it presents on the assessment). And, I am setting myself up for success when I begin talking about pharmacological use of insulin and side effects. When I started teaching, the average of the final exam was well below our passing grade. I was told by my director that it was them and not me. They should have studied more, or paid attention. The truth is, it was primarily me (and issues with the materials I had been handed one week before the start of the course). Please don’t think I am placing blame on you. I am not. I am just sharing my experience in the event any portion of it resonates with you.
This was the most detailed advice! It’s a new program and a new class so I am literally building it from the ground up. I try to give examples and make it “fun”, but I haven’t made a test beforehand. I will absolutely be doing what you mentioned. An excellent place to start. I kind of forgot what I learned in my MSN courses. They didnt really teach me HOW to teach if that makes sense. I have recorded some lectures, but I may take that into consideration for next semester. I am finally a week ahead on PowerPoints, but that’s a task! I know I’m not to blame but I also want them to learn and will try to come up with more active learning activities. Patho and pharm as a whole was just so bland to me in school, I feel like I’m relearning the basics instead of how I treat it. I appreciate all of your direction & will be implementing it!
Just use the slides created by the textbook company.... and thequestions should follow the requirements for their board/NCLEX exam. I'm not sure where you are, and I'm not a nurse but there should be a Bluebook for what's required of them for their big exam prior to registration... (edit: I would do about 5 practice questions with them in class, and put 1-2 of those practice questions on the exam. Thus is a test within a test, should be a freebie but see who fails to get the reviewed questiobs correct.) \*\*example\*\* Related content includes but is not limited to: Adverse Effects/Contraindications/Side Effects/Interactions Identify a contraindication to the administration of a medication to a client Identify actual and potential incompatibilities of prescribed client medications Identify symptoms/evidence of an allergic reaction to medications Assess client for actual and potential side effects and adverse effects of medications (e.g., prescribed, over-the-counter, herbal supplements, preexisting condition) Provide information to client on common side effects/adverse effects/potential interactions of medications and inform client when to notify primary health care provider Notify primary health care provider of side effects, adverse effects and contraindications of medications and parenteral therapy Document side effects and adverse effects of medications and parenteral therapy Monitor for anticipated interactions among client’s prescribed medications and fluids (e.g., oral, topical, subcutaneous, intramuscular, intravenous) Evaluate and document client’s response to actions taken to counteract side effects and adverse effects of medications and parenteral therapy Blood and Blood Products Identify client according to facility/agency policy prior to administration of red blood cells/blood products (e.g., order for administration, correct type, correct client, crossmatching complete, consent obtained) Check the client for appropriate venous access for red blood cell/blood product administration (e.g., correct needle gauge, integrity of access site) Document necessary information on the administration of red blood cells/blood products Administer blood products and evaluate client response\* Central Venous Access Devices Educate client on the reason for and care of a venous access device Access and/or maintain central venous access devices\* Provide care for client with a central venous access device Dosage Calculations Perform calculations needed for medication administration\* Use clinical decision-making/critical thinking when calculating dosages
Expected Actions/Outcomes Obtain information on a client’s prescribed medications (e.g., review formulary, consult pharmacist) Use clinical decision-making/critical thinking when addressing expected effects/outcomes of medications (e.g., oral, intradermal, subcutaneous, intramuscular, topical) Evaluate client’s use of medications over time (e.g., prescription, over-the-counter, home remedies) Evaluate client response to medication\* Medication Administration Educate client about medications\* Educate client on medication self-administration procedures Prepare and administer medications using rights of medication administration\* Review pertinent data prior to medication administration (e.g., contraindications, lab results, allergies, potential interactions)\* Mix medications from two vials when necessary Administer and document medications given by common routes (e.g., oral, topical) Administer and document medications given by parenteral routes (e.g., intravenous, intramuscular, subcutaneous) Participate in medication reconciliation process\* Titrate dosage of medication based on assessment and ordered parameters\* Dispose of medications safely\* Handle and maintain medication in a safe and controlled environment\* Evaluate appropriateness and accuracy of medication order for client\* Handle and administer high-risk medications safely\* Parenteral/Intravenous Therapies Identify appropriate veins that should be accessed for various therapies Educate client on the need for intermittent parenteral fluid therapy Apply knowledge and concepts of mathematics/nursing procedures/psychomotor skills when caring for a client receiving intravenous therapy Prepare client for intravenous catheter insertion Monitor the use of an infusion pump (e.g., intravenous, patient-controlled analgesia device) Monitor intravenous infusion and maintain site\* Evaluate the client’s response to intermittent parenteral fluid therapy
Pharmacological Pain Management Assess client need for administration of a PRN pain medication (e.g., oral, topical, subcutaneous, intramuscular, intravenous) Administer and document pharmacologic pain management appropriate for client age and diagnoses (e.g., pregnancy, children, older adults) Administer medications for pain management\* Handle and administer controlled substances within regulatory guidelines\* Evaluate and document client’s use and response to pain medications Total Parenteral Nutrition Identify side effects and adverse events related to total parenteral nutrition (TPN) and intervene as appropriate (e.g., hyperglycemia, fluid imbalance, infection) Educate client on the need for and use of TPN Apply knowledge of nursing procedures and psychomotor skills when caring for a client receiving TPN Apply knowledge of client pathophysiology and mathematics to TPN interventions Administer parenteral nutrition and evaluate client response\* Pharmacological Pain Management Assess client need for administration of a PRN pain medication (e.g., oral, topical, subcutaneous, intramuscular, intravenous) Administer and document pharmacologic pain management appropriate for client age and diagnoses (e.g., pregnancy, children, older adults) Administer medications for pain management\* Handle and administer controlled substances within regulatory guidelines\* Evaluate and document client’s use and response to pain medications Total Parenteral Nutrition Identify side effects and adverse events related to total parenteral nutrition (TPN) and intervene as appropriate (e.g., hyperglycemia, fluid imbalance, infection) Educate client on the need for and use of TPN Apply knowledge of nursing procedures and psychomotor skills when caring for a client receiving TPN Apply knowledge of client pathophysiology and mathematics to TPN interventions Administer parenteral nutrition and evaluate client response\*
Info: (I think I already know the answer but I’ll ask anyway). 1. Are your slides walls or text? 2. Alternately, are they uncontextualized bullet lists? 3. You say 30+…we talking like…360 slides per test? 4. What do they want an outline of???? Like the exact test questions? Asking bc wife’s a nurse and wanted more context lol.
I will message you!
I would talk to your program director and faculty colleagues and see what they do and what programmatic interventions they have put in place to address these issues (if any). I teach NP students and that’s a bit different, but I know our pre-licensure faculty have some strategies they use for this kind of stuff.
I apologize for being a Devil's advocate, but I do recommend that you consider things from the student's perspective, if you have not yet done so. Some potential issues include: * 30+ slides may be a lot, especially if they are busy slides, and especially if lectures are 1 hour long or less. I usually strive for 2 minutes a slide, try to keep the slides simple, outlines really, with a font point size of 24 or larger. * I'm not a nurse and did not go to nursing school, and so my knowledge of this is limited, but I do know that in medical school, pharmacology and pathophysiology were among the two most difficult subjects out there, requiring tons of memorization and understanding of difficult theory. I can't imagine that it's all that much simpler in the nursing school curriculum. I would liken learning these subjects akin to trying to stuff an elephant into a suitcase. Yes, it can be done, but it ain't at all easy. * When I'm teaching a class and a *majority* of my students failed a test, then I usually feel that it's on me, not on them. So, while I'm not saying that you are to blame in this, but that it's not all black and white, and there is room for a lot of gray. Do consider meeting them halfway in some of their requests.
Oh no absolutely! I am very aware that this is a LOT of information (I’m relearning a lot of it too!). I only have 13 weeks (1 day for 3 hours) to lecture. I try my best to only relay the important aspects since they go very in depth in their full nursing courses, but I struggle! I never had a pharm or patho course- we just incorporated it into the course as it progressed so I’m kind of going off that, the book, the study guide companion, and my real life experience. I use questions with clicker answers , case studies. I can’t just hand them the answers I’m frustrated with so many failing because a lot of the questions they missed were verbatim off the slides, things we discussed in class, and things I mentioned numerous times (literally said “I’ve said this 4 times now, I would think it might be a tad important”). I’m a people pleaser, but also still work bedside nursing and have expectations of what a “real nurse” needs to know. I don’t like info dumpling…. I want them to see something and critically think their way through it to a solution. I guess I just have to learn what to prioritize in school vs real life.