NR 621 Intervention:Evaluation Plan

Name

Chamberlain University

NR-621: Nurse Educator Concluding Graduate Experience I

Prof. Name

Date

Introduction:

Incivility in nursing education has become a persistent challenge, with manifestations occurring in both academic and clinical settings. Various stakeholders, including clinical placement preceptors, academic staff, students, and patients, contribute to this issue, which has physical and psychological consequences for its victims. Moreover, incivility in nursing education can have direct implications for patient care, as it may lead to unsafe practices and cloud clinical judgment. Research on effective interventions to reduce incivility in nursing education is limited, but role-playing has emerged as a promising strategy. The goal of this project was to perform a mixed-methods literature evaluation to identify role-playing techniques that could address incivility among nursing students and explore the outcomes of such interventions.

Nurse incivility is a critical issue within healthcare, as it has far-reaching effects on both the healthcare system and patient safety. Incivility can lead to intimidation, which may impair clinical judgment and jeopardize patient outcomes. In fact, studies indicate that incivility contributes to a significant number of fatalities, with an estimated 98,000 deaths annually in acute care settings. This issue not only impacts clinical practice but also affects nursing retention. High turnover rates due to incivility can be costly, with hospitals spending up to 125% of an individual nurse’s salary to replace each nurse who leaves due to these issues.

NR 621 Intervention:Evaluation Plan

Professional organizations, such as the Joint Commission and the American Nurses Association, advocate for zero-tolerance policies regarding disruptive behavior and emphasize the importance of addressing incivility to improve the healthcare environment. This project proposes the use of role-playing as a technique to engage nursing students in understanding the importance of civility in the healthcare setting and its potential impact on their future practice.

Role-playing as an educational strategy has been proven effective in various disciplines, including nursing, by promoting engagement and enhancing empathy. However, timing plays an important role in the effectiveness of role-playing interventions. For example, role-playing exercises should not be scheduled immediately before or after exams, as stress from the assessments can reduce the efficacy of the activity. In this project, careful consideration was given to the timing of the role-playing sessions to avoid conflicts with exams or other critical events. Through the strategic application of role-playing, nursing students are provided with opportunities to develop crucial communication skills and reflect on their roles as caregivers, which in turn fosters their sense of identity as nurses. The project further highlights the importance of integrating role-playing into nursing curricula to address incivility and promote professional development.

Project Goals and Stakeholders

The long-term goal of this proposal is to address and manage incivility within nursing education by implementing role-playing interventions. By using role-playing, educators can better equip students to respond to uncivil behavior when it occurs, while also enhancing their capacity to provide high-quality patient care. The successful integration of role-playing into nursing curricula will be evaluated through its impact on student learning outcomes, including NCLEX graduation rates, as well as faculty feedback on the intervention’s effectiveness in improving classroom dynamics.

The short-term goal is to assess the impact of role-playing on student performance, particularly mid-term exam results. The performance of students in exams before and after the introduction of role-playing techniques will be compared to determine whether the intervention leads to improved learning outcomes. Additionally, the role-playing technique will be evaluated in terms of its ability to enhance student engagement and reduce stress associated with clinical learning.

The project will involve collaboration with multiple stakeholders, including faculty members, administrators, and department chairs from five participating nursing schools. These institutions were selected through a competitive process, ensuring that they have the resources and commitment to implement role-playing effectively. The stakeholders are crucial in the development and evaluation of the intervention, as their support and involvement will influence the success of the project. Furthermore, the use of role-playing will be evaluated based on its alignment with the goals of critical pedagogy and emancipatory education, which emphasize active learning and the development of critical thinking skills in nursing students.

Project Implementation: Role-Playing in Nursing Education

To successfully integrate role-playing into nursing education, several factors must be considered, including faculty training, curriculum adjustments, and the development of appropriate scenarios. During the implementation phase, these factors will be carefully planned to ensure that role-playing activities are engaging and aligned with learning objectives. A variety of role-playing scenarios will be developed, including simulations of common healthcare interactions such as patient interviews, clinical assessments, and emergency care situations.

In one example of role-playing in mental health education, students were tasked with taking on the roles of both patients and healthcare providers during psychiatric interviews. The role-playing technique allowed students to explore the emotional challenges faced by both patients and clinicians, which led to increased empathy and improved communication skills. A study by Martin and Kahn (1995) found that such role-playing activities helped students understand patient behaviors and reactions more effectively. The students also reported that practicing these scenarios and receiving feedback on their performance helped build their confidence and reduce anxiety.

NR 621 Intervention:Evaluation Plan

In addition to mental health education, role-playing has been used to teach other essential clinical skills, such as conducting interviews and managing difficult patient interactions. For example, in a study focused on nursing students’ experiences with auditory hallucinations, students participated in a simulation where they donned headphones and experienced auditory hallucinations while completing various activities. After the simulation, students participated in a debriefing session where they reflected on their experiences and discussed how to improve communication with patients experiencing similar symptoms. The role-playing exercise increased students’ understanding of the challenges faced by individuals with mental health disorders and helped them develop greater empathy for patients.

Another important aspect of role-playing in nursing education is its ability to help students improve their clinical communication skills. In a study by King, Hill, and Gleason (2015), medical students participated in role-playing sessions that involved taking on the roles of both patients and healthcare professionals. The students reported that the sessions were beneficial for learning communication strategies and understanding the perspectives of both patients and providers. These findings suggest that role-playing not only enhances students’ clinical knowledge but also fosters the development of crucial interpersonal skills that are essential for effective patient care.

Conclusion: Evaluating the Impact of Role-Playing in Nursing Education

Role-playing interventions have shown significant promise in addressing incivility and improving communication skills among nursing students. By providing students with realistic scenarios in which they can practice and reflect on their actions, role-playing fosters empathy, self-awareness, and professional development. Furthermore, the use of role-playing in nursing education aligns with the principles of active learning and critical pedagogy, which emphasize the importance of student engagement and reflection in the learning process. The ongoing evaluation of role-playing interventions will help determine their effectiveness in reducing incivility, improving learning outcomes, and promoting a more supportive and respectful learning environment for nursing students.

NR 621 Intervention: Evaluation Plan

The intervention for this study used role-playing as a key educational method. The objectives of this intervention were varied, with three of the role-playing techniques focusing on role-playing as a teaching method, while the fourth aimed at exploring the students’ experiences with role-playing as a learning activity. Although the goals varied, the results were similar across the studies. Role-playing was found to improve students’ therapeutic knowledge, their attitudes, and their overall learning. Importantly, role-playing was identified as a tool that enhanced students’ capabilities as practitioners, helping them to develop critical skills necessary for their future roles in healthcare.

Quasi-Experiment

The quasi-experiment conducted sought to compare the effectiveness of lecture-based learning versus role-playing education on nursing students’ learning outcomes. The research aimed to explore the relationship between student characteristics and their scores on theoretical tests and role-playing checklists. At the start of the course, students were introduced to the benefits and relevance of role-playing in the educational process. The initial four lessons began with a lecture on key concepts, including the principles of patient training, instructor roles, and the various aspects of teaching and learning. During the second session, students were tasked with creating learning objectives in the cognitive, psychomotor, and affective domains for patient education.

The third session focused specifically on different teaching approaches, with an emphasis on role-playing. This workshop helped students understand the structure of role-playing and the creation of scenarios. During the fourth session, students were trained on evaluating patient teaching programs, followed by practical exercises where they applied the skills learned to real patients. In the final stages of the intervention, students performed role-play scenarios in front of their peers and instructors, with feedback provided to enhance the learning experience. The findings from this quasi-experiment suggested that the role-playing technique led to significantly higher scores compared to traditional lecture-based instruction, emphasizing its effectiveness in promoting student learning.

Project Evaluation

The evaluation of this project was conducted through a combination of faculty observations and student feedback. Faculty members, trained to assess the mentorship and teaching methods, used course evaluation forms to rate various aspects of the intervention. These included the effectiveness of online learning modules, the organization of role-playing activities, and the facilitation of student discussions. Additionally, students provided feedback via an end-of-course questionnaire, assessing whether their perceptions and learning experiences had changed as a result of the role-playing intervention. According to the student feedback, many reported an increased understanding of their own behaviors, particularly in terms of how they interacted with others in the learning environment.

NR 621 Intervention:Evaluation Plan

By reflecting on their actions, students were able to adjust and improve their behavior, enhancing the teacher-student relationship and fostering an environment of mutual respect and trust. Faculty members also reported that proper management of incivility in the classroom led to improved student engagement and participation, as students became more motivated to engage with the material and prepare for extracurricular activities. This was confirmed through interviews with both faculty and students, which highlighted the positive impact of the intervention on overall learning experiences and mentor-student relationships.

Change Model: Force Field Model and the Unfreezing-Change-Refreezing Model

The change model used in this intervention was based on Kurt Lewin’s three-step process, which includes unfreezing, movement, and refreezing. According to this model, individuals and groups must first “unfreeze” their existing behaviors and attitudes before moving to the next stage of change. Unfreezing involves identifying and addressing factors that resist change and fostering an openness to new ideas. In the context of this intervention, this meant moving away from traditional lecture-based learning and adopting role-playing as a more interactive and engaging method. The next stage, movement, involved the actual change in behaviors, attitudes, and practices. In this case, both educators and students had to shift their perspectives on teaching and learning, embracing role-playing as a powerful educational tool. Finally, refreezing refers to stabilizing the new behaviors and making them a permanent part of the learning environment. This final stage ensured that the role-playing method became a regular feature in the course, supported by both faculty and students. This approach to change, emphasizing the importance of addressing both driving and restraining forces, was crucial in ensuring the successful integration of role-playing as a pedagogical tool.

Self-Reflection

Reflection is a crucial component of both teaching and learning, particularly when addressing challenging behaviors such as incivility in the classroom. The experiences of both educators and students revealed that role-playing and reflective practices could be powerful tools in managing such behaviors. Educators were able to reflect on their teaching methods and past encounters with incivility to identify underlying causes and strategies for improvement. This reflection not only helped to enhance teaching practices but also boosted educators’ confidence in managing challenging classroom situations. For students, reflection on their own behavior, particularly when guided by instructors, allowed them to recognize and address disruptive actions. Through thoughtful consideration, many students were able to adjust their behavior, fostering a more productive and respectful learning environment.

Teaching-Learning Strategy

Several strategies emerged from this evaluation as being particularly effective in managing incivility and enhancing student engagement. These included the use of varied teaching methods to involve all students, particularly those who might be prone to incivility. The application of fair and transparent evaluation techniques helped students feel that their efforts were recognized and rewarded, contributing to a sense of equity in the classroom. Additionally, incorporating appropriate apprenticeship techniques that cater to different learning styles was found to be essential in managing challenging behaviors. By using engaging and motivating teaching strategies, educators could foster a more positive and respectful classroom environment, reducing instances of incivility and increasing overall student participation and satisfaction.

References

Burnes, B. (2020). The Origins of Lewin’s Three-Step Model of Change. The Journal of Applied Behavioral Science, 56(1), 32-59.

Deborah, O. K. (2018). Lewin’s Theory of Change: Applicability of its Principles in a Contemporary Organization. Journal of Strategic Management, 2(5), 1-12.

Mousavinasab, E., Kalhori, S. R. N., Sanaee, N. Z., Rakhshan, M., & Saeedi, M. G. (2020). Nursing process education: A review of methods and characteristics. Nurse Education in Practice, 102886.

Nes, A. A., Fossum, M., Steindal, S. A., Solberg, M. T., Strandell-Line, C., Zlamal, J., & Gjevjon, E. L. (2020). Research protocol: Technology-supported guidance to increase flexibility, quality, and efficiency in the clinical practicum of nursing education. International Journal of Educational Research, 103, 101628.

Radicchi, V. (2020). Technology and Nursing Education in Europe: A Literature Review.

NR 621 Intervention:Evaluation Plan

Williamson, K. M., & Muckle, J. (2018). Students’ perception of technology use in nursing education. CIN: Computers, Informatics, Nursing, 36(2), 70-76.

Martin, P., & Kahn, J. (1995). Medical students as role-playing patients. Acad Psychiatry, 19(2), 101–107. https://doi.org/10.1007/BF03341538

Rogers, C. (1994). Freedom to Learn. New York, NY: MacMillan College Inc.

King, J., Hill, K., & Gleason, A. (2015). All the world’s stage: Evaluating psychiatry role-play-based learning for medical students. Australasian Psychiatry, 23(1), 76–79.