Critical Thinking Module for LPN students  Speech Presentation

Hello everyone,

For the past couple of months, I have been working on my project of designing a curriculum to improve nursing education among Licensed Practice Nursing (LPN) students. This project was part of the requirements for full completion of my MSN Education program in this institution. Today’s discussion focuses on taking you through the steps I followed to fully complete the project. This presentation will take approximately 30 minutes and I will begin by going through the executive summary that highlights the most important aspects of the project.

Executive Summary

During my clinical practice experience, I was tasked with identifying gaps in the delivery of patient care among students and then using this information to propose a curriculum change. I chose to focus on LPN students where I noticed that they had difficulties in applying critical thinking during patient care. To improve upon this practice, I decided to propose a critical thinking course geared towards improving critical thinking skills for the selected student population. To fully develop the course, the ADDIE (Analysis, design, development, implementation, evaluation) model of curriculum design was utilized.

The first phase of the model, the Analysis Phase, involved the assessment of the learner’s needs and identification of the curriculum gap. Upon identification of the student’s needs, I proceeded to the design phase where I identified goals for the new course and how to achieve them using a multidisciplinary approach. In the development phase, I was tasked with developing the course content and assessments to determine student learning. The next phase involved the implementation of the new course into the LPN curriculum through education of students, administration of assessments, and determination of student learning. In the last phase, the evaluation phase, I was tasked with assessing student learning through the administered tests and student surveys.

Now let me discuss in detail each of these steps alongside other crucial aspects of the project.

Introduction to the Curriculum Proposal

We can all ascertain that today’s healthcare system is rapidly changing and the patient’s demands are increasing in complexity each day. Because of these changes, critical thinking is among the most valuable skills a nurse could possess to effectively manage the evolving needs of patients. While we expect all nurses to possess critical thinking skills, it is always a challenge for nurse educators to effectively prepare students to utilize critical thinking. However, various approaches can be used to prepare the students to think critically during their training and help improve critical thinking skills as they transition into the real nursing world. Lack of effective utilization of critical thinking skills among LPN students (Athens Technical College School of Nursing) is what prompted my development of the critical thinking course that I am discussing today. The aim of introducing this course into the LPN curriculum was to incorporate new learning strategies that could challenge the student’s minds into thinking critically during their routine care delivery to patients.

After understanding the background to the development of the critical thinking course, let us look at the theory underpinning this change.

Theoretical Framework

The theoretical framework that formed the basis of introducing the critical thinking course was the constructivist learning theory. As one of the most prominent theories of learning, constructivism is based on the idea that learners are active participants in their learning journey and that knowledge is constructed based on experiences. It is observed that learners reflect on their experiences and incorporate new ideas into prior knowledge as events occur and the learner selects and transforms information, constructs hypotheses, and makes decisions relying on cognitive structure. The constructivist theory also affirms that learning is an active mental process or work that takes place through activity. To apply this theory during learning, it was observed that using active learning strategies could engage the student’s mind into thinking critically. I will discuss the active learning strategies supported by this theory later. But they include group discussions, simulation-based learning, online discussion boards, and flipped classrooms.

The constructivist learning theory is based on different principles or elements that demonstrate the acquisition of knowledge. For instance, knowledge is constructed meaning that learners build upon their learning by adding more knowledge into the pre-existing one. Secondly, the theory affirms that learning is a social activity meaning that social interactions promote knowledge acquisition. Other key principles of this theory include: Learning is an active process, learning is contextual, learning exists in the mind, knowledge is personal, and motivation is key to learning. All these aspects supported the introduction of the critical thinking course and the utilization of active learning strategies to improve critical thinking skills among LPN students.

Just like any other academic research, a literature review was for the project to obtain solid academic support for the proposed change.

Let me take you through the literature review process that I performed.

Literature Review

I obtained relevant literature to support the development of the critical thinking course through the school library. The school librarian was of great importance during this exercise. To provide a solid ground for my proposal, I reviewed a minimum of 10 sources that purely focused on critical thinking and critical thinking development in nursing education. I proceeded to summarize the literature to include the strength of evidence, findings from each article, and the strengths and weaknesses of each research. Upon completion of this summary, I reviewed common ideas and discussions to come up with several common themes that support the project proposal.         Let us look at the findings from the literature review.

Literature Findings

The first aspect that I analyzed was the reason for the observed critical thinking challenges among students. I realized that many organizations experienced the challenge of preparing students to think critically due to various reasons. Firstly, I noticed that the lack of enough focus on changing the nursing curriculum hindered the incorporation of new ways to nursing education today. The second reason was the lack of faculty knowledge on how to foster new approaches to student learning. Lack of collaborative approaches in various institutions also hindered the effective development of critical thinking courses for nursing students while fear for change also contributed to the same.

The second theme that I came up with was o the challenges facing nursing education today. I realized that most literature underlined the failure of nursing education alignment with clinical nursing practice as a common issue. What students were taught in class was not a true reflection of what they experienced in their clinicals. Too much focus on theory made it difficult for students to apply knowledge in clinical nursing practice. The second finding from the literature review was on the constituents of critical thinking. I observed that critical thinking skills mainly involved analyzing, interpretation, self-regulation, and evaluation. The literature also identified common barriers to critical thinking teaching and learning in nursing schools. These barriers included too much focus on traditional teaching, student-tutor ratios, and organizational culture. Lastly, I was able to identify the learning strategies that can be incorporated into the LPN nursing curriculum and the new course to improve critical thinking among students. These strategies included simulation-based learning, online discussions, group discussions, and other active learning strategies.

As discussed earlier during the introduction, the ADDIE model was utilized to develop the critical thinking course or module for LPN students.

Let me take you through the model and how it was applied in the project.

ADDIE Model

The ADDIE model is a curriculum instruction design model that provides a dynamic and flexible guideline for training and performance assessment. The model consists of five stages that I will go through briefly.

Analysis- This is the firsts phase that usually involves determining the needs of the students and the gap to be filled.

Design- This phase involved determining learning objectives, strategies to achieve the objectives, and the evaluation strategy.

Development- The focus of this phase is the refining of the learning resources and pilot testing to ascertain the workability of the new curriculum.

Implementation-This phase involves preparation of learning environment, training of learners, and managing learning activities.

Evaluation- This is the last phase of the model that involves the administration of surveys and the comparison of results.

Now let us look at what activities took place in each phase of the model during the curriculum design.

Analysis Phase

This phase started during my clinical practice experience where I observed students from Athens Technical College School of Nursing. I realized that the students had challenges in applying critical thinking during patient care delivery. To further understand the problem, I consulted with the academic nurse educators in the school where we reviewed the LPN curriculum to identify gaps in education. I realized that the existing curriculum did not adequately prepare students to utilize critical thinking skills in their clinical areas. To effectively solve this challenge there was a need to involve nurse educators, learners, and the administration to integrate a critical thinking module into the current LPN curriculum. Apart from the analysis of student learning, I analyzed the organizational readiness for change through a force-field analysis process. I was able to identify the strengths and weaknesses of the organization that helped further in strengthening the curriculum proposal.

Design Phase

The design phase mainly involved collaboration with stakeholders like academic nurse educators, students, and the administration to come up with a critical thinking module that could benefit learners. During the initial meeting with stakeholders, I proposed my solution of including a critical thinking course into the current LPN curriculum and incorporation different learning strategies to support the change. It was during this stage that I came up with course objectives and how learners would benefit from the course. These objectives required that upon completion of the course, students would be able to:

1. Apply deductive and inductive reasoning in making clinical judgment when implementing the nursing process.
2. Analyze the steps of the nursing process as an inquiry method during critical thinking application.

iii. Analyze coping skills when communicating with patients across all age groups.

1. Develop solutions to language problems like ambiguity and vagueness that hinder therapeutic communication in healthcare.
2. Compare appropriate research in the analysis, construction, and evaluation of arguments

To effectively achieve the above objectives, different strategies were laid. Firstly, the critical thinking module could utilize teaching strategies like case-based learning, simulation-based learning, and flipped classrooms. Secondly, different instructional delivery models including face-to-face learning, team-based learning, and online learning were incorporated. Additionally, the critical thinking module could utilize a variety of learning materials including journal articles, textbooks, online videos, and case studies for the engagement of students. Coming up with the above conclusions required a lot of time for holding meetings and discussing to agree upon each aspect. Because of the current COVID-19 pandemic and associated restrictions, other communication methods like emails, phone calls, and zoom meetings were used to effectively engage all stakeholders.

The objectives were reviewed by the expert clinical nurse educators and we all agreed to move forward to the curriculum development phase. Let me go through the various activities that took place during the development phase.

Development Phase

The development phase was utilized to anchor the new course into the current curriculum and to observe any changes that could lead to better outcomes. The approach to this phase used both independent and collaborative approaches. For instance, I independently managed to perform a literature review and identification of gaps in the current LPN curriculum. Collaboratively, we managed to discuss the curriculum gap, identify learning resources and learning methods that could improve critical thinking. Key stakeholders involved during the collaborative practices included the administration, nurse educators, school librarian, and information technologists.

The second phase of the development stage involved coming up with assessments that could be used to determine student learning. Collaborative approaches with the academic nurse educators led to the development of three assessments; formative assessment, summative objective assessment, and summative performance assessment. The formative assessment for the critical thinking module focused on testing the student’s understanding of the course and how learning could be improved. Five questions were developed for this assessment. The second part was the summative objective assessment that aimed at assessing the student’s understanding and mastery of content. This assessment could utilize 10 multiple choice questions and had a 10% contribution in the final grading. The last assessment was performance-based and it utilized a case scenario to actively engage students. The participation of students in the simulation and answering a short essay could translate to a 20% score in the final grading.

Coming up with these assessments marked the end of the development phase. Now let us have a look at the implementation phase.

Implementation Phase

The main activities during this phase involved the determination of required resources, allocation of the resources, and training of the students and nurse educators. Both human and financial resources were required to facilitate the implementation of the course. For instance, nurse educators were required to teach the newly developed course to nursing students. The information technology team was required to ensure the new learning strategies like online discussion boards were available through the utilization of technology. The financial resources required for the project Pointed towards the conduction of the pilot study, training of academic educators, and payment of employees. Regarding training, the nurse educators were required to be trained on how to implement the critical thinking module and utilization of new learning strategies like simulation-based learning. Completion of these steps could see full implementation of the new curriculum to await evaluation.

The last step I want to address is the evaluation phase.

Evaluation Phase

After a long period of curriculum design and development, evaluation was necessary to ascertain the workability of the new changes. The key performance indicators for the success of the project include the participation of students, engagement of nurse educators, completion of the course by students, and passing of final examination by students. For instance, the success of the new strategy to critical thinking could be observed through completion of the module by more than 80% of the learners and passing of the tests by more than 75% of the learners. The second part of the evaluation focused on feedback from the students regarding the quality of education given and understanding of the course. I developed the end-of-course survey that included 10 items rated using a Likert scale. I believe the student’s response and the final examination scores will be used to determine the effectiveness of the course in improving critical thinking among LPN students from Athens Technical College School of Nursing.

Thank You.