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Nursing Pathway for Lecture Prep

Dr. Sarah Garcia-Portillo DNP, MSN-Ed, BSN, RN

ACC Professional Nursing Dept.

Academic Nurse Tutor

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Target Population: Higher Education��Full time and Adjunct Faculty primarily sciences�Nursing Students�Distance Education, HyFlex, Hybrid, In Person����Objectives:��1. Communicate the need for lecture preparation PRIOR to lecture�2. Amplify the expectations and resources at each start of semester.�3. Provide student support to ease barriers or challenges that are identified.�4. Understand that knowledge, comprehension, application & analysis of the module content information can develop critical thinking & clinical judgement.��

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Nursing Students Have Gaps & Bridges in Learning

Lack of

-organization

-time management

-meaningful reading

AMPLIFY

-HOW to STUDY: Process (start to end)

-Use Quality RESOURCES

  • Nurse Educator Based
  • Module Preparation
  • ACC Retention Resources

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Student Expectations

  • Nurses do not have an Academy and structure is needed
  • Belief that a Professor should provide information for CONTENT during lecture

- Poor attendance to lecture: work or other

  • May put work before learning: cost of living in

Austin, Texas or illness

  • Unmet expectations....now what? Not like TV
  • Must have the conversation with friends or family of your study needs…

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Balance, Organize, & Adhere

Organization:

  • Use your ACC Google Calendar
  • Synch your phones to ACC Email
  • Plot your Study & Prep Activities

Often, ruminating about just trying to find time to study is tough to start.

Emphasis

LECTURE Prep is performed BEFORE Lecture

Layered Notes are Used During Lecture

Exam Prep is performed afternoon of Lecture

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Monday’s: Prep for lecture (BB Mod obj)

 

Class/Lecture Take notes in diff color ink

Lab- is it am or pm?

Class/Lecture: Topic?

Take notes in diff color ink

Clinical or

START MON lecture BB Mod

Lunch

Lunch

Need structure and break

Lunch

Lunch

Lunch

Lunch

Lunch

Wed’s lecture BB Mod

25 NCLEX ?s on Lecture Topic(s)

After lunch

Prep For Lab

25 NCLEX ?s on Lecture Topic(s)

Prepare Clinical assignment

Clinical/SIM

START Wed lecture BB Mod

 

BREAK

Don’t stay up studying for an exam night before. Instead, wake up 2-3 hrs earlier to review

Don’t cram for exams, eat the feast one bite at a time- one module at a time

 

Note: Use Off-Clinical Days to prep for next week’s lecture (Mon-Fri). Don’t schedule work the day before an exam.

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Quality Lecture Preparation Hybrid/Distance Ed/In Person

  • Orient the students to the BB Module Objectives
  • Methodical 🡪 always
  • Meaningful Reading: Copy & Paste objs. on a new/blank Word Document, Highlight the content directives or possible exam worthy keywords
  • Follow Course Calendar, syllabus & Exam schedule
  • Ticket to Class

Professors that lecture, also assign students to the relatively passive role of listening and many students are unable to apply information from lecture in a meaningful way (Waldeck & Weimer, 2017).

Active learning increases students' retention of information and improves performance on course exams (Styers, Van Zandt, & Hayden, 2018; Ulrich et al., 2017).

Prior to the pandemic, there was a compelling literacy problem specifically to reading (Horning, 2022)

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Module 9: Neurosensory Disorders: CVA BB Module Objectives�

This module will cover the following disorders:

• Ischemic Stroke

• Hemorrhagic Stroke

Utilizing clinical reasoning and the nursing process, the student is expected to:

1. Analyze the etiology, pathophysiology, risk factors, signs and symptoms, complications, medical management, and nursing care of the above disorders.

2. Integrate associated diagnostic tests and determine associated nursing care of the above disorders.

3. Analyze relevant prioritized nursing diagnoses and an associated nursing plan of care to address physical, psychosocial, and learning needs.

4. Prioritize and evaluate patient and family centered goals and outcomes that facilitate health promotion, maintenance, and restoration.

5. Utilize evidence-based practice to prioritize, implement, and evaluate nursing interventions to address the needs of diverse and vulnerable patients/families with social determinants of health that contribute to multiple body system problems.

• Medication therapy

• Diet therapy

• Surgical interventions

• Patient teaching; therapeutic communication

• Others

6. Explain ways to collaborate with the interdisciplinary health care team when providing patient-centered care including during local or global health events.

7. Apply legal and ethical considerations including service excellence and nursing peer review.

8. Examine complementary medicine options and quality improvement initiatives including civility and just culture.

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CVA Module Objectives: This module will cover the following disorders: Stroke (Cerebral Vascular Accident/Brain Attack)·         Ischemic Stroke (thrombus, clot)·         Hemorrhagic Stroke (bleed)Analyze the etiology, pathophysiology, risk factors, signs and symptoms, complications, medical management, and nursing care (interventions) of the above disorders. Time between lack of blood and brain dysfunction (TIA/CVA)�Artery involved- Patho�-Manifestations: disease process (occlusive/hemorrhagic), blood vessel affected, hemisphere involved, and length of time. the brain is without blood supply. �-Motor deficits (one sided), elimination disorders, sensory-perceptual deficits, language disorders, cognitive & behavioral changes, Vision, changes in other body systems. �Complications: (IICP) increased intracranial pressure= how is it relieved- osmotic diuretics0 surgical procedure---- Burr holes/craniotomy/craniectomy/cranioplasty�Hemorrhagic CVA- aneurysms- complication- rebleeding= clipping of aneurysm, coils, other�Vasospasm and/or hydrocephalus�Diagnostic Test: Computer tomography (CT), Magnetic resonance imaging (MRI); Labs for coumadin, heparin therapeutic levels�Angiography, Transcranial ultrasound doppler, Positron emission tomography (PET) full body, EEG, OtherSafe environment: Risk reduction🡪 disabilities, anticoagulant safety consideration bleeding precautionsMedication therapy:Brain tumors: corticosteroids, chemotherapy�Occlusive (ischemic) stroke:tPA; anti thrombolytics; anticoagulants; anticonvulsants�Hemorrhagic stroke: never use tPAAntihypertensives, calcium channel blockers (Nimodipine), anticonvulsants, stool softeners, analgesics, other�

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Spoiler Alert! BREAKDOWN the Disease (or Disorder) Process

Utilizing clinical reasoning and the nursing process, the student is expected to:

1. Analyze the etiology, pathophysiology, risk factors, signs and symptoms, complications, medical management, and nursing care of the above disorders.

  1. Integrate associated diagnostic tests and determine associated nursing care of the above disorders.
  2. Medications, safety, teaching, etc.….

Use a Spreadsheet or Content Map for organization of the content:

  • Name of disease, define it
  • Etiology (cause), Patho, Risk factors (modifiable & non-modifiable)
  • Assessment: S/S, Complications
  • Diagnostics: Labs, Radiology, Special Procedures (is it Medical/Surgical?)
  • Medications: Include Teaching and Nursing Interventions
  • Teaching: Patient teaching, Diet, disease management
  • post surgical care

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How Can We Supplement Learning Without Overwhelming Students with Resources?

Ideas to Incorporate:

  • Supplemental Learning *Ticket to Class to make sure it was done before class.
  • Add Meds to know- aligned with the disease process & lecture
  • Layer in Lecture Notes over data collected in different INK color
  • Nurse Educator Nurse Educator Video Tutorials : Level up RN, RegisterednurseRN.com, Simple Nursing, Osmosis…..
  • Digital Flashcards from Evolve Text
  • Breakout groups for each of the elements of the disease breakdown
  • NCLEX Exam Practice Questions in the lecture, quiz, kahoot
  • with emphasis on the rationales
  • Use Meaningful Reading
  • Library Resource links for practice NCLEX question guides

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Professor PPT Slide Samples- �Aligned to Objectives…

Thrombolytic Therapy

  • What type of stroke needs to be confirmed?***
  • Tissue Plasminogen Activator (tPA)
    • *Treatment must be initiated promptly after CT
      • Reestablish blood flow through blocked artery – How?
      • Other fibrinolytic agents cannot be substituted for tPA
      • *IV tPA MUST be administered within 3 to 4.5 hours of symptom onset*
      • May be given intraarterial ( up to 6 hours)
        • Inserts catheter femoral artery and guides to clot where directly administers tPA to clot
        • Less tPA needed and lower chances of systemic bleeds/intracranial hemorrhage
      • **Control of BP is critical! <180/105 for 24 hr**
      • Timing is the most important factor here!!
    • Nursing orders:
      • Insert foley
      • Insert NG tube
      • Establish multiple large bore IV

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Aligned Exam Practice Questions ��For tissue plasminogen activator (tPA) to be most effective in the treatment of ischemic stroke, it must be administered?�A. 10 hours after the onset of stroke symptoms�B. 9 hours before the onset of stroke symptoms�C. 3 hours after the onset of stroke symptoms�D. 12 hours before the onset of stroke symptoms��The answer is C. �tPa dissolves the clot causing the blockage in stroke by activating the protein that causes fibrinolysis. It should be given within 3 hours after the onset of stroke symptoms. It can be given 3 to 4.5 hours after onset IF the patient meets strict criteria. It is used for acute ischemia stroke, NOT hemorrhagic!!��

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Knowledge

The emphasis is on recalling remembered information.

Comprehension

The emphasis is on understanding the meaning and intent of remembered information.

Application

The emphasis is on remembering understood information and utilizing the information in new situations.

Analysis

The emphasis is on comparing and contrasting a variety of elements of information.

NCLEX Style Exam Questions for Nurses apply knowledge, comprehension, and use analysis to prioritize critical decisions for safe competent nursing.

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Blueprint or Formula for Applying Critical Thinking To Answering �Multiple-choice Questions in Nursing

USE the RACE Model for practice NCLEX Exam Questions

The components of the RACE Model are:

R — Recognize what information is in the stem.

A — Ask, What is the question asking?

C — Critically analyze the options in relation to the question asked in the stem.

E — Eliminate as many options as possible

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Academic Tutor Referral form for Nursing Students

& faculty in the Professional Nursing Dept.

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We are all carrying a bag. We don’t know what load (challenges/barriers) the adult learners are carrying?

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Resources

SAS Referral Form Student Accessibility Services (SAS) Excellent form to get the conversation started for more information pertaining to accommodations for students

Retention Coordinator for Health Sciences Referral Forms: Instructor or Student self-referral

Student Success Coach for Re-entry students accessible through the Nursing Director

Student Resources navigates needs *add the link to your signature email setting

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Add a Resources & Nurse Tutor Tab to the BB Course �Add a resource link to your email signature ��

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Skills Videos in your BB Course

Use Evolve textbooks (eBooks & text resources) online:

digital flash cards, chapter questions, key point outlines of chapters

Content specific case scenarios and more…

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Email Signature sample with student resources embedded

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- Meet after the Module Objectives are completed�- Don’t disseminate homework�- Do Practice Questions after lecture�- Focus on rationales, don’t memorize�- Virtual meeting is still an option�-ACC Accelerators, Public Libraries for in person make great study locations

Study Groups

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Student nurses can benefit from organization, time management, prepping before lecture, and applying their knowledge to successfully bridge the gap to their success.

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Success & Bridging the GAP with Lecture Prep

Clear communication & expectations, resources, engagement, collaboration & assessment findings = STUDENT SUCCESS

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Start Here. Get There.

Dr. Sarah Garcia-Portillo DNP, MSN-Ed, BSN, RN