ddevonshire msn-ed comprehensive essay exam

D. Devonshire MSN-ED Comprehensive Exam 1

MSN-ED Comprehensive Essay Exam

Denise Devonshire, BSN, RN

Graduate Student

Aspen University

29 July 2015


Comprehensive Exam

The following comprehensive essay will provide the necessary content to validate this

writer’s knowledge and comprehension of nursing education as taught by the staff of Aspen

University which meets the criteria for the MSN Nursing Education degree completion program.

Theory and Framework

When an individual becomes a nurse they learn about the profession’s very first nurse

theorist, Florence Nightingale, and the contributions she made to the science of nursing. She

provided the field with such compassion for the science of nursing that lead to her monumental

work which she published in 1859. This published work Notes on Nursing (McEwen & Wills,

2011) described her personal thoughts of how nursing healed the sick and the environment in

which they were cared for directly resulted in how well the patient recovered from their illness or

wound. As the nursing individual grows in their nursing career they begin to understand the

multifaceted arena in which nursing science involves. When the nursing individual wants more

in their career they have the option to choose to advance their own vision and framework to

become an advanced scholar in their field of expertise.

Nursing education is just one the fields in which a Registered Nurse can engage in

advanced thinking and pursue and advanced degree. It is the nurse educator’s (NE) role to pass

along the knowledge, resources and educational objectives to obtain personal and professional

goals. As one of the roles of a nurse educator it is important to understand the theorist that

shares the same goals and thoughts as the nurse educator.

Virginia Henderson was a nurse educator with documented practice theory as early as the

1920-1930’s. Her work contributed to the science of nursing throughout her lifetime. The


theory in which she developed and contributed to is “The Principle and Practice of Nursing”.

This theory focused on the patient’s needs and care. She believed her theory best explained that

nurses can care for their patients until the patient can care for themselves, which at that point the

nurse is no longer needed (McEwen, 2011, p. 127). With her work on the principles and practice

of nursing she was able to develop the 14 activities which help to assist a client in their daily

lives. She formulated the patient should breath normally; eat and drink adequately; eliminate

bowl waste; move and maintain best body posture; sleep and rest; select suitable clothing;

maintain adequate body temperature; daily hygiene; communicate with others; worship

according to one’s own faith; work to a sense of accomplishment; play and have fun in

recreation; and learn, discover and satisfy one’s own curiosity (McEwen, 2011, p. 127).

Virginia Henderson’s theory best identifies with most nurse educators who visualize the

nursing practice she was able to compose and document it’s success. This theory is based on

compassion and understanding of patient care and the nurse’s ability to provide care until the

patient no longer warrants such nursing action. To better relate this to the writer’s own

philosophical framework, this writer believes in the act of teaching to give the student enough

knowledge and resources which will enhance their ability to go on their own and teach others as

they have been taught. This writer has adopted the “see one, do one, teach one” philosophy. This

philosophy has worked well in the writer’s workplace as this writer would explain the rationale

for the action and the needed steps to a student/corpsman/nurse. The “do one” helps to solidify

the teaching method and objectives of the nursing action. Once this step has been achieved then

the student is able to teach one which then sets their own teaching method in place.

Giving the student the opportunity to learn to provide for the client until the client is able

to care for themselves was once said to be teaching ourselves out of a job. But, this writer


believes in Virginia Henderson’s theory which places the nurse at the side of the client.

Teaching the client about their particular disease or health process and how to manage that

process is going to benefit the client in the long run. Giving students this knowledge and

resources to educate not only clients, but fellow co-workers will give them the ability to become

competent nurse educators. A good nurse educator will give the student the knowledge to make

successful critical thinking decisions and allow them to make those decisions on their own.

If the opportunity were to arise to develop a framework for a nursing program, Virginia

Henderson’s Principle and Practice Nursing theory would be the base framework from which to

build upon. The nurse educator would also understand there can be so much more than just

deciding what theory should be used, but how will this framework develop to produce competent

critical thinking nurses that can work in a diverse healthcare system. Virginia Henderson’s

theory would be an example of a single theory framework as described in Teaching in Nursing

(Billings, 2012). These are questions each nurse educator in the academic field should be able to

answer and provide evidenced based rationale for.

National League of Nursing: Nursing Education Core Competency

The eight core competencies for nursing education display the competent skills that

reflect the nurse educator’s ability to function in the role as either an academic or clinical nurse

educator. These eight core competencies “reflect the essential knowledge, skills, values, and

beliefs of nursing faculty” (Utely, 2011). As with the State Board of Nursing for Registered

Nurses each nurse should reflect the competencies in order to practice as a Registered Nurse.


Facilitate Learning

The first of the eight total nurse educator competencies involves the nurse educator

becoming a facilitator of learning. According to Utley (2011) the first core competency is the

broadest of all of the competencies. This competency incorporates 14 task statements which

involve knowledge, skill and values that are vital to the teaching process. As a Registered Nurse

as one of our assessment tools, ADPIE (assessment, diagnosis, plan, implement, and evaluation)

is in fact to assess the environment and the situation in order to prioritize nursing tasks. As a

nurse educator the same assessment tool is used to assess the learning environment. The nurse

educator will need to use skills to make the environment enticing for the learner. When the

environment is dry and non-engaging the learner will not maintain an attention span that would

greatly benefit their learning curve. It is important for the nurse educator to grab the attention of

the student when they walk in the door and to maintain that attention throughout the learning

session. It is also important for the nurse educator to build relationships with the students in

order to form positive bonds that benefit the nurse educator, the student and the learning

environment.

An example this writer would use to demonstrate how to execute a positive learning

environment and help facilitate learning would be to meet with each individual and determine

what their goals are for the class or overall education. Say for example, this is for a class a

meeting would be held to determine what their expectations are and what are they wanting to

achieve when they are done. As a nurse educator for a postpartum unit in a hospital ward, this

writer would meet with each nursing individual to determine what path they seek to fulfill. A

plan would be made with a timeline of achievement. After each objective was met recognition


of the goal would be placed on a particular wall. This would give the other employees the

opportunity to meet their own objectives and be recognized for their hard work.

Facilitate Learner Development and Socialization. Core competency two details how

the nurse educator will facilitate the learner’s development and socialization. This core

competency is an extension of core competency one. Core competency one describes the NE role

is teaching both clinical and didactic content which facilitates the learners initial learning

process. Core competency two describes the NE role to help the student to acclimate to the

nursing role and to recognize the adverse effects of the transition to the nursing profession

(Utely, 2011, p. 137).

This core competency allows the NE to identify which student needs extra help in

learning and adjusting to this new role. Not every student will be able to learn from a

PowerPoint™ presentation, but they may learn better from hands on practice and discussion

which sets the information into the long term memory spaces of their mind. An example of this

core competency would be problem based learning (PBL) exercises. The PBL exercise allows

the students to confront real world problems in an exercise format. It allows them to use

critically think skills about a case which helps them to determine what is the best course of

action for this particular patient’s situation (DeYoung, 2009). This method of teaching allows

the NE to conduct the PBL in small groups and grants the students to learn based on little

knowledge of the subject. This gives the NE an opportunity to assess each student’s strengths

and weakness and makes adjustments as necessary to enhance the learning environment.

Use Assessment and Evaluation Strategies. Core competency three is defined as the

NE use of assessment and evaluation strategies of the learner’s progress in the course. This can

be used in any setting which teaching occurs (classroom, clinical, skills laboratory, or online


settings) (Utely, 2011, p. 177). It is best to understand the terms assessment and evaluation.

Assessment is the “broad and comprehensive process of collecting quantitative and or qualitative

data to make informed educations decision about students” (Utely, 2011, p. 178) and the types of

evaluation when applied at the individual’s level would be to determine if the student learned the

content and to what degree of learning that occurred for the student (Utely, 2011, p. 178).

An example of this core competency would be concept mapping and/or reflective writing.

These two evaluation tools are widely used among NE’s in any setting to assess the learner’s

ability to gather information and then to evaluate the comprehension of the material. Concept

mapping is a graphic detailed map which connects the relationship of the main idea and how it

branches out to smaller subset ideas that are involved in the illness or disease. This map can be

very simple or it can be very involved and mapped on a large scale. This map allows the student

to plot many courses (bubbles) of thought all branching off the main subject line. This writer

would use this type of assessment and evaluation tool to allow the student to plot down their

many ideas of the illness and how that affects the patient’s life. This allows the NE to discuss

any plot lines not thought of and how this affects the patient’s overall health.

Reflective writing is a “purposeful contemplation of thoughts, feelings, and happiness

that pertain to recent experiences” (Utely, 2011, p. 197). This allows the student to reflect on the

day or procedure and to explore those feelings. This normally reflects critical thinking skills

from the learner which grants the NE to determine the learner’s particular learning style and

comprehension of material. According to DeYoung (2009) critical thinking is not easy and

requires the development of such skills takes effort and time. One minute papers can also be

used to determine the learner’s comprehension and understanding of the content. This permits

the students to jot down in one minute the most important points they understood from a lecture


or discussion. The one minute paper gives the NE an idea if the learner is on the right track or if

a meeting should occur to help the student get back on track of the learning objectives of the

class.

Participate in Curriculum Design and Evaluation Program Outcomes. Core

competency number four involves the NE participation in curriculum design and the evaluation

of the program outcomes. This involves the complete idea of curriculum design which involves

the assessment of the program needs to planning the evaluation techniques of the program’s

outcomes. This allows the NE to integrate changes in the curriculum based on the

recommendations from the licensing board and accrediting agencies.

Curriculum development involves determining the theory and theoretical underpinnings

that will be the basis of the program and then formulating courses based on the theory statement.

Curriculum development can change with the times, such as when health care needs change, a

change in the demographics of the local population, an increase in health disparities, and any

change in the standards of practice by professional organizations (Utely, 2011, pp. 240-241).

The most important part of the curriculum development is the program evaluation

process. It determines if the program is successful or needs adjustment to meet the educational

needs of the students. There are several models of program evaluation to date. Using the right

one will help the program succeed. To name just a few of the program evaluation models they

are: Iwasiw’s components of curriculum evaluation which assess several essential components

starting with curricular philosophy; Chen’s program evaluation tool is a theory driven approach

that emphasizes the elements of the program and the program interventions; learning evaluation

and program effectiveness model asks the question “What is happening within the program?

(Utely, 2011, p. 259), which they explore the programs vision, mission and goals of the program


along with the educational process and learning outcomes and the domains of learning and the

evaluation plan and effectiveness determinants.

Function as a Change Agent and Leader. Core competency number five involves the

NE as a leader in change theories which utilizes a range of concepts that achieve goals and give

the NE the ability to change and manage the teaching and learning environment. To be an

effective leader there are several theories that explain how a leader is either made or born to lead.

There are trait theories, behavioral theories, situational theories, transactional theory,

transformational theory, dispersed leadership theory, and social-cultural leadership theories.

Each contribute to the core competency of the nurse educator acting as a change agent and

leader.

The trait theory is an example of the Great Man theory which describes the person who is

born with the innate leadership quality. This theory describes this person who has charisma,

intelligence, task motivation, social skill, administrative skills and emotional control (Utely,

2011, p. 277). In the behavioral theory there are types of performance leaders which are Theory

X and Y Managers. Theory X managers are individuals who lack motivation and need direction

in order to function. Theory Y managers are individuals who actively seek responsibility and

can self-direct to achieve goals. These managers are go-getters and are self-motivated to

perform.

A change agent and leader should be someone who, in their daily work environment as a

Registered Nurse would step up and take charge in a crisis environment. Using the simulation

lab to re-enact a crisis scenario and having each student demonstrate how they would manage the

situation would determine which student is a natural leader who does not need instructions on


what needs to be done. This involves the critical thinking skills that have been taught thus far in

the program and will show in the students confirmed learning comprehension.

Pursue Continuous Quality Improvement in the Nurse Educator Role. Core

competency number six involves the benchmarking process of the curriculum design. A

benchmark is defined as a measure of best practices. It also involves sharing successful program

initiatives and learning form other’s success (Utely, 2011, p. 321). There are eight steps to the

benchmarking process. They are to identify the area of interest, define the benchmarks,

determine the type of benchmarking process that will be used, identify the attributes of

benchmarking peers, gather benchmarking data, analyzation of the data, use the data for

improvement process, and the evaluation of the results.

As an educator in an academic setting this competency is focused on the NE ability to

maintain the knowledge and skills that are needed to fulfill the teaching, scholarship, and service

role functions as a nurse educator. Mentoring is one action in which an established NE can help

a novice NE to become and retain the knowledge and skills that are needed for the particular

program.

Engage in Scholarship. Core competency number seven involves the NE ability to

engage in scholarship such as activities that enhance the teaching and nursing practice,

developing nursing theory and broadening the knowledge base of the nursing practice (Utely,

2011, p. 349). According to Utely (2009) who paraphrased Emerson and Records work in 2007,

scholarly teaching and scholarship of teaching are differentiated by the scope of practice.

Scholarly teaching uses knowledge of teaching along with the knowledge of the subject matter to

aid in their particular educational practice. Scholarship of teaching describes the type of research

which the teaching and learning is explored, tested, and the results are disseminated.


Boyer’s Pillars of Scholarship Model (Utely, 2011, p. 355) discusses the model of

fostering scholarship. This model is structured in a way it resembles a Parthenon like structure

which includes discovery, application, integration, and teaching. Discovery is a life-long process

of learning which involves the discussion of “validate and refined existing knowledge and/or

generate new knowledge” (Utely, 2011, p. 355); application is the reflection of interaction of

current nursing knowledge, theory and practice which new ideas can formulate from; integration

involved the “holistic synthesis of knowledge that incorporates and promotes interdisciplinary

and collaborative relationships” (Utely, 2011, p. 356).

Through the continuous action of research and publication of renewing work in the

nursing process and teaching theory field can the nursing profession advance in scholarship

activity. Nurse Educators should participate in ongoing scholarship of renewing and advancing

the nursing practice. Without continual and engaging scholarship the nursing practice and

teaching become stagnant and do not make advances in the nursing practice and teaching of

scholarly content.

Function Within the Educational Environment. Core Competency number eight is the

final competency of the National League of Nursing Nurse Educator competencies. This

particular core competency reflect the skills and processes that are needed to put in motion the

institutions goals, mission and philosophy. NE should understand the content in which they are

going to teach and the goal of the program. They will teach, use technology, engage in

leadership, formulate change and become a political advocate for the nursing practice in the

academic setting.

Nurse Educators should be active in their local and state nursing profession associations.

These nursing associations meet at a national level to vote on the most pressing issues that occur


in the nursing profession and practice. These votes influence how nursing programs teach

required content to validate nursing comprehension and the ever changing health care system.

The best example of this action would be to join the state nurses association such as Virginia

Nurses Association and on a broader level the American Nurses Association. Attending

meetings on a local level can help to shape the nursing practice which then can be proposed at

the national level and induces change nationally.

Teaching Plan

Guest Lecture for 3rd Year Nursing Students. Deciding on what the best course of

activities that would help these 3rd year nursing students to succeed in verbal return of the

pathophysiology and pharmacology of a hospitalized diabetic patient will help this writer to

determine what will capture their interest. The lecturer will have two hours in which to fill the

time period with engaging activities that will help the students to set their knowledge in stone

after this lecture and feel more confident in their ability to think critically as a nurse.

Audience. Thirty 3rd year nursing students in a local nursing program. These students

have a solid foundation of the pathophysiology and pharmacology of diabetes. These students

are preparing for their final year of nursing school which will train them to become competent

Registered Nurses.

Setting. The setting of this teaching session would occur in the classroom at the nursing

school.

Objectives: Upon completion of this learning session the students will be able to:

Recognize diabetic ketoacidosis, diabetic neuropathies, and skin integrity

deficiencies.


Recognize and recall what an American Diabetic Diet consist of. Determine how

many snacks the diabetic individual would need to maintain adequate blood sugar

levels.

Determine what would be the correct intervention would be for an individual with

low blood sugar levels or high blood sugar levels.

Recognize the pharmacologic medications used to control blood sugar levels.

Teaching Theory: The Theory of Human Becoming by Rosemarie Parse is the learning

theory in which it could be used for these nursing students. Rosemarie Parse composed three

broad statements which described her theory. These statements are “1) human becoming is

freely choosing personal meaning is situation in the intersubjective process of living value

priorities; 2) human becoming is cocreating rhythmical patterns of relating in mutual process

with the universe; 3) human becoming is cotranscending multidimensionally with the emerging

possibles” (McEwen, 2011, p. 193).

This theory was chosen because this writer feels these students are a vessel of learning

and have the opportunity to teach the diabetic individual about the condition and how to manage

this condition. Being human gives the individual the ability to decide how they will live. These

individuals have the power to either change or keep the same homeostatic function they live in.

Teaching nursing students compassion and empathy will also enhance their knowledge base for

diabetic teaching. They can use the strategies learned in the classroom to back up their

knowledge they present to the patient and family.

Teaching method. The teaching method this writer chose to use to reaffirm the

knowledge these students possess would be to use the game strategy. Lectures are a good way to

disseminate information, but the student will need to verbally return the knowledge the lecture


gave them. Games are a great way to not only present new information, but return to previously

learnt information.

The games this writer brain stormed to use would be a Family Feud™ and Jeopardy™

type games. Jeopardy has been used before and is favored among most students. When students

find out this is not the normal learning/listening period of class they get more excited because it

is not the norm they are used to. There are 30 students in the class which would need to

participate in the activity. Each student would be required to participate as it would be a part of

their weekly grade for class. The two games would split the students up. Each team would have

15 students which then would be divided into 7-8 students per team for each game.

This writer has never seen Family Feud used as a classroom game before and would think

the students would greatly enjoy this activity. The students would be divided into two teams and

each member would answer the question or questions. This game could easily take up an hour or

more as this writer would think it would be a fun activity. The other set of students would then

play the Jeopardy game. Each student who answered the question correctly would get a candy or

some small token of achievement. These games are meant to stimulate the mind and at the same

time have fun. When the mind is stressed the thoughts cannot come as easily as it would if it

was in a fun learning environment.

Advantages of this learning module would be excitement and fun as each person is

participating and listening to the answers. Some students may not have remembered an answer

that could be valid in the care of a diabetic patient. New information is learned all the time from

games like this that other students may have forgotten because there is so much content to

remember about this healthcare disparity. Disadvantages of these games would be not everyone


is truly participating in the games and possibly not every student enjoys being up in front of the

class which hinders their thinking process.

To evaluate the games a post evaluation would be handed to each student to determine if

these games would be used again. If the games were a flop other activities would be pursued

such as crossword and word find puzzles. Students would be able to comment on what they

would like to see again and what they felt was not an advantage to their learning.

If the students felt these games were not a success then other activities that could be used

would be problem based learning (PBL) exercises. These exercises would help the students to

become vessels of teaching. PBL’s as described in Bradshaw & Lowenstein (2014) have been

used in the past and are used throughout the world. Students could be in teams or individual

basis and work on the diabetic teaching plan for this in-patient diabetic individual. Concept

mapping could also be used to help the students solidify this information. This writer would not

choose to use concept mapping as a way to fill two hours of class time. Fun, interactive games

would be the avenue in which this writer would pursue to engage the students in this

teaching/learning activity. These students would then enter the nursing profession and conduct

teaching while they reflect on this activity to be sure they include different ways to convey the

information.


References

Billings, D. &. (2012). Teaching in nursing: A guide for faculty (Fourth ed.). St. Louis: Elsevier Saunders.

Bradshaw, M. &. (2014). Innovative teaching strategies in nursing and realted health porfessionals (Sixth ed.). Burlington, Ma.

DeYoung, S. (2009). Teaching strategies for nurse educators (Second ed.). Upper Saddle River, NJ: Pearson Prentice Hall.

McEwen, M. &. (2011). Theoretical basis for nursing (Third ed.). Philadelphia: Lippincott Williams & Wilkins.

Utely, R. (2011). Theory and research for academic nurse educators. Sudbury, Ma. : Jones and Bartlett Publishers.

ddevonshire msn-ed comprehensive essay exam

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