Integrating elements of undergraduate curriculum learning

Integrating elements of undergraduate curriculum learning Rapidly advancing practice and recognition of nursing, midwifery and medicine as a vital interrelated workforce, implies a need for a variety of curricula opportunities. This project addresses the challenge for healthcare educators to widen student engagement and participation through inter-professional education by creating learning environments whereby student interactions foster the desire to develop situational awareness, independent learning and contribution to patient advocacy. Overall aim of this ‘Feeding and Nutrition in Infants and Children’ project is to provide opportunities for integrated learning to enable students to advance their knowledge and understanding of current best practice. This Inter-professional (IPE) student-lead workshop was initially implemented in 2006-07 in collaboration with the Centre for Excellence in IPE, within the curricula of medical and nursing programmes¹. Supported by the development of a student resource pack, this project is now being offered to Learning Disability nursing and Midwifery students since September 2014. Methods: Fourth year medical students, undertaking a ‘Child Healthcare module’, alongside nursing and /or midwifery students are divided into groups with three or four students from each profession. Each group focuses on a specific feeding problem that is scenario-based on a common real-life issue prior to the workshop and then present their findings / possible solutions to feeding problem. They are observed by both facilitators and peers, who provide constructive feedback on aspects of performance including patient safety, cultural awareness, communication, decision making skills, teamwork and an appreciation of the role of various professionals in managing feeding problems in infants and children. Results: Participants complete a Likert-scale questionnaire to ascertain their reactions to this integrated learning experience. Ongoing findings suggest that students evaluate this learning activity very positively and have stated that they value the opportunity to exercise their clinical judgement and decision making skills. Most recent comments: ‘appreciate working alongside other student’s / multidisciplinary team approach’ As a group students engage in this team problem-solving exercise, drawing upon their strengths and abilities to learn from each other. This project provides a crucial opportunity for learning and knowledge exchange for all those medical, midwifery and nursing students involved. Reference: 1. Purdy, J. & Stewart, M (2009) ‘Feeding and Nutrition in Infants and Children: An Interprofessional Approach’. The Clinical Teacher, vol 6, no.3. Authors: Dr. Angela Bell, Centre for Medical Education, Queen’s University Belfast. Doris Corkin, Senior Lecturer (education), Children’s Nursing, School of Nursing & Midwifery, Queen’s University Belfast. Carolyn Moorhead, Midwifery Lecturer, School of Nursing & Midwifery, Queen’s University Belfast. Ann Devlin, Lecturer (education), Learning Disability Nursing, School of Nursing & Midwifery, Queen’s University Belfast.

Cultivating creative learners in higher education: Engaging students in anatomy through art

Introduction
Nursing and midwifery students often struggle to engage with bioscience modules because they lack confidence in their ability to study science (Fell et al., 2012). Consequently many have difficulty applying anatomical and physiological information, essential to providing safe and effective patient care (Rogers, 2014; Rogers and Sterling, 2012); therefore a need exists for nurse educators to explore different methods of delivery of these important topics to enhance current curricula (Johnston, 2010). Inspired by the reported success of creative methods to enhance the teaching and learning of anatomy in medical education (Noel, 2013; Finn and McLachlan, 2010), this pilot study engaged nursing students in anatomy through the art of felt. The project was underpinned by the principles of good practice in undergraduate education, staff-student engagement, cooperation among students, active learning, prompt feedback, time on task, high expectations and respect for diverse learning styles (Chickering and Gamson, 1987).

Method
Undergraduate student nurses from Queen’s University, Belfast, enrolled in the year one ‘Health and Wellbeing’ model were invited to participate in the project. Over a six week period the student volunteers worked in partnership with teaching staff to construct individual, unique, three dimensional felt models of the upper body. Students researched the agreed topic for each week in terms of anatomical structure, location, tissue composition and vascular access. Creativity was encouraged in relation to the colour and texture of materials used. The evaluation of the project was based on the four level model detailed by Kirkpatrick and Kirkpatrick (2006) and included both quantitative and qualitative analysis:• pre and post knowledge scores• self-rated confidence• student reflections on the application of learning to practice.

Results
At the end of the project students had created felt pieces reflective of their learning throughout the project and ‘memorable’ three dimensional mental maps of the human anatomy. Evaluation revealed not only acquisition of anatomical knowledge, but the wider benefits of actively engaging in creative learning with other students and faculty teaching staff.

The project has enabled nurse educators to assess the impact of innovative methods for delivery of these important topics.

An Exploration of Political Consciousness Amongst Final Year Nursing Students in Northern Ireland

Context and background
Historically nurses perceive politics and nursing as being at odds with the caring image, synonymous with nurses (Salvage, 1985). Furthermore the concept of the ‘politics of nursing’ lacks clear conceptual clarity (Hewison, 1994). This concept ranges across a continuum from political interest to participation or engagement (Rains et al, 2001). It is often argued political interest tends to be equated with knowledge/ involvement in health policy development and nurse education can foster political consciousness, through political socialization (Brown, 1996). But despite the World Health Organization (WHO, 2002) urging this involvement, nurses globally are largely absent from the political and policy making arena. What influences nurse’s political socialization and the development of a political consciousness is not clearly identified or known, although many commentators suggest the undergraduate educational environment, plays an important role (Hanley, 1987, Winter, 1991).     

AIM
The aim of this study was to explore third year nursing student’s perceptions of politics in nursing, in the context of Northern Ireland. A number of hypotheses were tested examining the relationship between age, prior educational attainment and political interest and attitudes.  

Research methodology
A cross sectional research design was used and the data was collected using a short anonymous self-completion web survey (Bryman, 2012). The sample was a convenience sample of one cohort of final year adult nursing students (n154) in one Northern Irish university, with a 42% response rate. Data was analyzed using SPSS.

Key findings and conclusions
The results revealed 55% of students were very/fairly interested in politics, with 6% reporting no interest in politics. 85% of students were registered to vote, but only 48% voted in the 2010 N Ireland Assembly election.   
Recommend inclusion of a unit of study incorporating innovative teaching methods related to politics and health related policy, in the undergraduate nursing programme.       

Developing Entrepreneurial Skills in Pharmacy Students

Objective. To create, implement, and evaluate a workshop that teaches undergraduate pharmacy
students about entrepreneurship.
Design. Workshops with 3 hours contact time and 2 hours self-study time were developed for final-year
students. Faculty members and students evaluated peer assessment, peer development,
communication, critical evaluation, creative thinking, problem solving, and numeracy skills, as well
as topic understanding. Student evaluation of the workshops was done largely via a self-administered,
9-question questionnaire.
Assessment. One hundred thirty-four students completed the workshops. The mean score was 50.9
out of 65. Scores ranged from 45.9 to 54.1. The questionnaire had a response rate of 100%. Many
students agreed that workshops about entrepreneurship were a useful teaching method. Additionally,
they agreed that key skills were fostered.
Conclusion. Workshops effectively delivered course content about entrepreneurship and helped
develop relevant skills. This work suggests students value a program that includes instruction on
entrepreneurship.

Trends in material choice for direct restorations by final year students from University College Cork 2004-2009

Traditionally, undergraduate students in University College Cork (UCC) have been taught to use amalgam as the first choice material for direct restoration of posterior cavities. Since 2005 the use of composite resins has replaced amalgam as the first choice material. An audit was conducted of all direct restorations placed by final year students from UCC from 2004 until 2009. Results showed that over a six year period, final year UCC dental undergraduate students placed proportionately more direct composite resin restorations and significantly fewer amalgam restorations. The need for and undergraduate exposure to, provision of amalgam restorations may have to be revisited.

An evaluation of Lab Tutor from the Nursing Student’s Perspective

The efficiency of large group teaching (lectures) has long been called into question with much research high lighting low levels of student participation, and poor attention spans leading to a lack of engagement with learning which inhibits deep learning. Small group teaching and Enquiry Based Learning (EBL) are methods of teaching that can help promote deep learning. There is also a growing need and demand for Technology Enhanced Learning to suit changing lifestyles. The Labtutor® System, is one such piece of software that is designed to incorporate EBL and small group teaching quality into the large group setting.

This study provides a descriptive survey of adult nursing student’s perceptions of the Labtutor system following its use in two Life Science modules within an undergraduate nursing programme. A convenience sample of first year adult nursing students (n= 115) were identified to complete a 32 item questionnaire (appendix three).
Participants reported overall that they enjoyed using the system and found it beneficial to their learning specifically:
(a) Increased engagement with material in online learning as a result of using the system.
(b) Increased participation and levels of interactivity in the lecture as a result of using the system.
(c) Increased enhancement of learning as a result of using the system and
(d) Usefulness of the formative assessment facilitated by using the system.

The study concludes that Labtutor® system and other such methods of Technology Enhanced Learning packages if used correctly can enhance learning.

Reaching out: medical students leading in local communities

Background: Queen's University Red Cross is a medical student-led volunteer group with a key aim of promoting social change within local communities and empowering young people to aspire to higher education. We describe ‘The Personal Development Certificate’, a 12–week community development programme devised by third-year medical students at Queen's University Belfast to target young people who are lacking educational motivation, are disengaged at home or are marginalised through social circumstances.

Context: Community-based education is of increasing importance within undergraduate and postgraduate medical education in the UK, and further afield. We evaluated the perceived improvements in key skills such as teamwork, leadership, communication, and problem solving in students following participation in this programme, and the extent to which their attitude and appreciation of community-based medicine changed.

Innovation: Following facilitation of this community-based initiative, all students reported a perceived improvement in the acquired skill sets. Students made strong links from this programme to previous clinical experiences and appreciated the opportunity to translate a series of classroom-learned skills to real-life environments and interactions. The students’ appreciation and understanding of community-based medicine was the single most improved area of our evaluation.

Implications: We have demonstrated that medical students possess the skills to develop and facilitate their own educational projects. Non-clinical, student-led community projects have the potential to be reproduced using recognised frameworks and guidelines to complement the current undergraduate medical curriculum

How should teaching on whole person medicine, including spiritual issues, be delivered in the undergraduate medical curriculum in the United Kingdom?

Background

Although the General Medical Council recommends that United Kingdom medical students are taught ‘whole person medicine’, spiritual care is variably recognised within the curriculum. Data on teaching delivery and attainment of learning outcomes is lacking. This study ascertained views of Faculty and students about spiritual care and how to teach and assess competence in delivering such care.

A questionnaire comprising 28 questions exploring attitudes to whole person medicine, spirituality and illness, and training of healthcare staff in providing spiritual care was designed using a five-point Likert scale. Free text comments were studied by thematic analysis. The questionnaire was distributed to 1300 students and 106 Faculty at Queen’s University Belfast Medical School.

351 responses (54 staff, 287 students; 25 %) were obtained. >90 % agreed that whole person medicine included physical, psychological and social components; 60 % supported inclusion of a spiritual component within the definition. Most supported availability of spiritual interventions for patients, including access to chaplains (71 %), counsellors (62 %), or members of the patient’s faith community (59 %). 90 % felt that personal faith/spirituality was important to some patients and 60 % agreed that this influenced health. However 80 % felt that doctors should never/rarely share their own spiritual beliefs with patients and 67 % felt they should only do so when specifically invited. Most supported including training on provision of spiritual care within the curriculum; 40-50 % felt this should be optional and 40 % mandatory. Small group teaching was the favoured delivery method. 64 % felt that teaching should not be assessed, but among assessment methods, reflective portfolios were most favoured (30 %). Students tended to hold more polarised viewpoints but generally were more favourably disposed towards spiritual care than Faculty. Respecting patients’ values and beliefs and the need for guidance in provision of spiritual care were identified in the free-text comments.

Students and Faculty generally recognise a spiritual dimension to health and support provision of spiritual care to appropriate patients. There is lack of consensus whether this should be delivered by doctors or left to others. Spiritual issues impacting patient management should be included in the curriculum; agreement is lacking about how to deliver and assess.

A study exploring disordered eating patterns in first-year university students: student and service needs

This qualitative study explored disordered eating in a small group of first-year undergraduate students and addresses a gap in the literature by exploring their lived experience.

Aims: To better understand student’s needs in those experiencing or at risk of developing disordered eating during their first year at university and to illustrate what support mechanisms and services are required to better support students experiencing or at risk during their first year at university.

Conclusion: The University could further develop its outreach to new students with a more consistently supportive programme providing better facilities and training for stress appraisal and coping and more support via student buddying. The University could also extend its programme on positive mental health in an attempt to better inform on disordered eating and to reduce a sense of stigma within the student population. Personal tutors and student health care facilities need to be consistently trained in the understanding and person centred approach to students experiencing disordered eating, particularly the sub-clinical group. In addition the University could consider some small changes and adaptations to the refectory eating areas to better facilitate students who may be at risk from disordered eating. Finally the University could perhaps better use the potentially liminal period within the first few months of student's arrival at university (a new beginning) to help embed a program to develop a stronger sense of coherence and well-being.

Mathematics Learning Support in Ireland in 2015

The provision of mathematics learning support in higher-level institutions on the island of Ireland has developed rapidly in recent times with the number of institutions providing some form of support doubling in the past seven years. The Irish Mathematics Learning Support Network aims to inform all mathematics support practitioners in Ireland on relevant issues. Consequently it was decided that a detailed picture of current provision was necessary. A comprehensive online survey was conducted to amass the necessary data. The ultimate aim of the survey is to benefit all mathematics support practitioners in Ireland, in particular those in third-level institutions who require further support to enhance the mathematical learning experience of their students. The survey reveals that the majority of Irish higher-level institutions provide mathematics learning support to some extent, with 65% doing so through a support centre. Learners of service mathematics are the primary users: first-year science, engineering and business undergraduates, with non-traditional students being a sizeable element. Despite the growing recognition for the need to offer mathematics learning support almost half of the centres are subject to annual review. Further, less than half the support offerings have a dedicated full-time manager, while 60% operate with a staff of five or fewer. The elevation of mathematics support as a viable and worthwhile career in order to attract and retain high quality staff is seen by many respondents as the crucial next phase of development.

Comparing Social Work Students' Perceptions of Risk Using Online Discussion Fora: Lessons Learned from a European Pilot Project

Comparisons of international child welfare systems have identified two basic orientations to practice; a ‘child protection’ orientation and a ‘child welfare’ orientation, which are founded upon fundamentally different values and assumptions regarding the family, the origins of child care problems, and the proper role of the state in relation to the family. This paper describes a project which sought to compare how undergraduate social work students from three European Universities perceive risk in referrals about the welfare of children and to explore the impact of different cultural, ideological and educational contexts on the way in which risk is constructed by students. Students from Northern Ireland, Germany and Poland examined three vignettes via ten online discussion fora each of which provided a narrative summary of their discussion. The paper presents some findings from the analysis of the qualitative data emerging from the student discussions and draws out the lessons learned in terms of how the project was designed and implemented using online discussion fora.

Undergraduate interprofessional education using high-fidelity paediatric simulation

BACKGROUND: High-fidelity simulation is becoming increasingly important in the delivery of teaching and learning to health care professionals within a safe environment. Its use in an interprofessional context and at undergraduate level has the potential to facilitate the learning of good communication and teamworking, in addition to clinical knowledge and skills.

METHODS: Interprofessional teaching and learning workshops using high-fidelity paediatric simulation were developed and delivered to undergraduate medical and nursing students at Queen's University Belfast. Learning outcomes common to both professions, and essential in the clinical management of sick children, included basic competencies, communication and teamworking skills. Quantitative and qualitative evaluation was undertaken using published questionnaires.

RESULTS: Quantitative results - the 32-item questionnaire was analysed for reliability using spss. Responses were positive for both groups of students across four domains - acquisition of knowledge and skills, communication and teamworking, professional identity and role awareness, and attitudes to shared learning. Qualitative results - thematic content analysis was used to analyse open-ended responses. Students from both groups commented that an interprofessional education (IPE) approach to paediatric simulation improved clinical and practice-based skills, and provided a safe learning environment. Students commented that there should be more interprofessional and simulation learning opportunities.

DISCUSSION: High-fidelity paediatric simulation, used in an interprofessional context, has the potential to meet the requirements of undergraduate medical and nursing curricula. Further research is needed into the long-term benefits for patient care, and its generalisability to other areas within health care teaching and learning.

An evaluation of the Socrative (personal response system) app for increasing student engagement and learning in an undergraduate psychology curriculum.

Personal response systems using hardware such as 'clickers' have been around for some time, however their use is often restricted to multiple choice questions (MCQs) and they are therefore used as a summative assessment tool for the individual student. More recent innovations such as 'Socrative' have removed the need for specialist hardware, instead utilising web-based technology and devices common to students, such as smartphones, tablets and laptops. While improving the potential for use in larger classrooms, this also creates the opportunity to pose more engaging open-response questions to students who can 'text in' their thoughts on questions posed in class. This poster will present two applications of the Socrative system in an undergraduate psychology curriculum which aimed to encourage interactive engagement with course content using real-time student responses and lecturer feedback. Data is currently being collected and result will be presented at the conference.
The first application used Socrative to pose MCQs at the end of two modules (a level one Statistics module and level two Individual Differences Psychology module, class size N≈100), with the intention of helping students assess their knowledge of the course. They were asked to rate their self-perceived knowledge of the course on a five-point Likert scale before and after completing the MCQs, as well as their views on the value of the revision session and any issues that had with using the app. The online MCQs remained open between the lecture and the exam, allowing students to revisit the questions at any time during their revision.
This poster will present data regarding the usefulness of the revision MCQs, the metacognitive effect of the MCQs on student's judgements of learning (pre vs post MCQ testing), as well as student engagement with the MCQs between the revision session and the examination. Student opinions on the use of the Socrative system in class will also be discussed.
The second application used Socrative to facilitate a flipped classroom lecture on a level two 'Conceptual Issues in Psychology' module, class size N≈100). The content of this module requires students to think critically about historical and contemporary conceptual issues in psychology and the philosophy of science. Students traditionally struggle with this module due to the emphasis on critical thinking skills, rather than simply the retention of concrete knowledge. To prepare students for the written examination, a flipped classroom lecture was held at the end of the semester. Students were asked to revise their knowledge of a particular area of Psychology by assigned reading, and were told that the flipped lecture would involve them thinking critically about the conceptual issues found in this area. They were informed that questions would be posed by the lecturer in class, and that they would be asked to post their thoughts using the Socrative app for a class discussion. The level of preparation students engaged in for the flipped lecture was measured, as well as qualitative opinions on the usefulness of the session. This poster will discuss the level of student engagement with the flipped lecture, both in terms of preparation for the lecture, and engagement with questions posed during the lecture, as well as the lecturer's experience in facilitating the flipped classroom using the Socrative platform.

Can Future Managers and Business Executives be Influenced to Behave more Ethically in the Workplace? The Impact of Approaches to Learning on Business Students’ Cheating Behavior

This study considers the potential for influencing business students to become ethical managers by directing their undergraduate learning environment. In particular, the relationship between business students’ academic cheating, as a predictor of workplace ethical behavior, and their approaches to learning is explored. The three approaches to learning identified from the students’ approaches to learning literature are deep approach, represented by an intrinsic interest in and a desire to understand the subject, surface approach, characterized by rote learning and memorization without understanding, and strategic approach, associated with competitive students whose motivation is the achievement of good grades by adopting either a surface or deep approach. Consistent with the hypothesized theoretical model, structural equation modeling revealed that the surface approach is associated with higher levels of cheating, while the deep approach is related to lower levels. The strategic approach was also associated with less cheating and had a statistically stronger influence than the deep approach. Further, a significantly positive relationship reported between deep and strategic approaches suggests that cheating is reduced when deep and strategic approaches are paired. These findings suggest that future managers and business executives can be influenced to behave more ethically in the workplace by directing their learning approaches. It is hoped that the evidence presented may encourage those involved in the design of business programs to implement educational strategies which optimize students’ approaches to learning towards deep and strategic characteristics, thereby equipping tomorrow’s managers and business executives with skills to recognize and respond appropriately to workplace ethical dilemmas.

Acute care teaching in the undergraduate nursing curriculum

AIM: To incorporate basic aspects of acute care into the undergraduate nursing programme by providing an opportunity for the development of knowledge and skills in the early recognition and assessment of deteriorating patients on general hospital wards.
BACKGROUND: Acute care initiatives implemented in the hospital setting to improve the identification and management of 'at risk' patients have focused on the provision of education for trained or qualified staff. However, to ensure student nurses are 'fit to practice' at the point of registration, it has been recommended that acute care theory and skills are incorporated into the undergraduate nursing curriculum.
PRACTICE DEVELOPMENT INITIATIVE: An 'Integrated Nursing Care' module was incorporated into year 3 of the undergraduate nursing programme to introduce students to acute care theory and practice. Module content focuses on the early detection and management of acute deterioration in patients with respiratory, cardiac, neurological or renal insufficiencies. We used a competency-based framework to ensure the application of theory to practice through the use of group seminars. High-fidelity patient-simulated clinical scenarios were a key feature. The United Kingdom Resuscitation Council Intermediate Life Support course is also an important component of the module.
CONCLUSIONS: Incorporating the Integrated Nursing Care module into the undergraduate nursing curriculum provides pre-registration students the opportunity to develop their knowledge and skills in acute care.
RELEVANCE TO CLINICAL PRACTICE: The provision of undergraduate education in care of the acutely ill patient in hospital is essential to improve nurses' competence and confidence in assessing and managing deteriorating patients in general wards at the point of registration.