Leigh Davis And Moira Cordiner 2008

Leigh Davis And Moira Cordiner 2008

• 1.
  Not Another Essay!Transforming assessment in an evidence-based practice nursing unit Dr Leigh Davis Ms Moira Cordiner
• 2.
  Session Overview Describethe process we used to design and deliver the first iteration of an EBP curriculum Present the first iteration of the curriculum with students’ and teachers’ evaluations Suggest implications to inform future iterations so that the effectiveness of the curriculum is improved .
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  What is EvidenceBased Practice? Is about making clinical decisions “on the basis of the best available scientific evidence but recognizing patient preferences , the context of healthcare and the judgment of the clinician.” Pearson, A., et al., The JBI model of evidence-based healthcare. International Journal of Evidenced Based Healthcare, 2005. 3 : p. 207-215.
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  Why the moveto Evidence Based Practice (EBP)? Increasing volumes of health care research. Rising health care expenditure Health care professionals are accountable for their own practice Consumers are becoming more informed Reduce the variation in practice decisions Important to healthcare quality assurance processes and accreditation
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  A model forEvidence Based Practice Translation of uncertainty to an answerable question Systematic retrieval of best evidence available Critical appraisal of evidence for validity, clinical relevance, and applicability Application of results in practice Incorporation of evidence into hospital policies, guidelines Using evidence in our everyday practice Evaluation
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  EBP and UniversityCurricula Universities have begun to incorporate EBP in undergraduate healthcare degrees No evidence to design or evaluate an EBP undergraduate nursing curriculum Ciliska, D. (2005). Educating for Evidence-Based Practice. Journal of Professional Nursing 21 , (6), (pp345-350)
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  Implementation of firstiteration Team: discipline expert + academic staff developer 3 steps: Understand cohort characteristics Design a major assessment task – ‘not another essay’ Scaffold students’ learning
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  Excerpt of theclinical scenario You are a newly registered nurse working at Matilda Memorial country hospital.  A 3 year old child with no known pre-existing medical conditions is admitted to the hospital with fever of unknown origin for investigation.  Nurses at the hospital manage uncomplicated fever differently. The hospital’s Director of Nursing has asked you to: identify the best available evidence on the nursing management of uncomplicated fever in children propose a draft policy based on the information you find.
• 9.
  Evaluation of firstiteration Three sources of data: University-wide voluntary student evaluation of the unit (quantitative and qualitative data) anecdotal information from students and tutors the means of students grades/marks for the worksheet and the major task
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  Evaluation (cont)Feature of the unit % satisfied/very satisfied (N=194) Assessment: Level of difficulty 62% Assessment - Relevance to Topic 72% Relevance of the tutorial sessions 72% Written Assessment Mean Worksheet 15 marks 10.9 Major Essay “ Submission for a practice change” 50 marks 34
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  Limitations 1. Problems with the first data source (QUT student evaluation of unit) not from a randomised sample of students from the unit we have no input into the generic construction of the survey. survey administered by the university three weeks before students have submitted the major task or sat for their exam small number of comments (44) - qualitative data is not representative. 2. University policy prevents us from: matching characteristics of particular students to the feedback they give us obtaining details about the cohort, e.g. percentages who were mature-aged; the tertiary entrance scores of students who started the degree directly from high school, and the ratios of ESL students
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  What did thedata indicate? most students found the subject relevant and could achieve reasonable results in the assessment tasks only 62% found the difficulty level satisfactory, despite the fact that the subject was at an introductory level diverse and opposing opinions about the unit’s relevance, difficulty, challenge of major task, placement of the unit in the degree many students ‘ described ’ rather than analysed and synthesised research information failure rate not high – comparable to other units
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  Main problem: insufficientalignment construct validity not as high as intended authentic task but construct validity compromised by insufficient authentic learning of EBP skills before applying them in the worksheet and major task
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  Conclusions change thepedagogy in tutorials to provide more scaffolding practice of analysis and synthesis skills reinforcement and feedback ( Caldwell, 2007 ) remove the requirement for students to produce a ‘policy document’ as part of the major task –is too challenging
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  Reflection transformed somestudents views about assessment underestimated the amount of practice third year students needed to develop analysis and synthesis skills believe that EBP should be incorporated into all units and not be offered as a standalone unit