By Tonya Schneidereith, PhD, CRNP, CNE, CHSE-A, ANEF, FAAN, University of Maryland and Susan Gross Forneris, PhD, RN, CNE, CHSE-A, FAAN, National League for Nursing
In 2020, the pandemic required most nursing programs to halt all in-person activities, including didactic lessons and clinical experiences. The rapid transition to virtual formats forced educators to find opportunities to meet those objectives most frequently achieved in clinical rotations. Experts in simulation pedagogy were essential to identify and provide virtual resources and facilitate online experiences aligned with simulation best practices.
What emerged from these months of collaboration was greater exposure to the elements in simulation that make for effective teaching and learning. Because these elements are not confined to simulation and can be used in any learning space, we hope to describe how they can be applied across all learning environments.
- Prebriefing: Setting the context for the learning encounter. Prebriefing creates a context for learning by setting the boundaries of the learning space. Placed at the beginning of the learning encounter, this time is used to set the tone for the learning experience, including our desire to view learners as trying their best and wanting to improve. By establishing a psychologically safe space, the teacher-learner experience becomes a dialogue where the teacher seeks to understand the thinking and sense-making behind the learner’s actions.
As you start the prebriefing, be explicit regarding expectations and help learners feel safe, free to share thoughts and ask questions. Provide reassurance that no one will be humiliated in the conversations that follow. By providing this foundation, the discussions can include all learners. The goal is to help develop the learner and not humiliate or condemn. Changing the frame of reference in this way will lead to a more impactful and effective learning experience.
- Learning outcomes: Beginning with the end in mind. Outcomes provide the foundation for the entire learning experience. Creating a context for the learning space sets the stage for the experience. The learning space becomes transparent when both the educator and the learner know what content is being discussed, how the content will be used, the direction we will take, and how learning is assessed.
Outcomes also tell us about our learners, who bring to the encounter their past learning, experiences, culture, ideas, assumptions, and rules. These enhance the conversations we share with our learners as we move to achieve the outcomes. Learning outcomes not only provide us with a better understanding of the level of our learners’ understanding, but also dictate how we will engage our learners in using the content. Learning outcomes drive the simulation experience and, likewise, drive all encounters with our learners (Forneris & Fey, 2021).
- Lesson plans: Every good learning encounter is driven from a plan. A plan brings to life the learning space and operationalizes the learning outcomes outlined for that encounter. This would mean that the PowerPoint is not your lesson plan! A lesson plan provides clarity for both the educator and the learner, with learning outcomes serving as the anchor of the plan. For each learning outcome the educator creates: 1) an outline of the necessary content with which the learner will engage; 2) the specific teaching strategy and level of learning that will be used to best engage the learner (this gives learners the opportunity to retrieve what they already know and practice using it, transfer the learning to analyze the same content in a different context, and reflect on their thinking); 3) time on task, that is, how much time should be dedicated to the teaching strategy being used; and 4) how the learning will be assessed.
Much like simulation, the lesson plan is the detailed scenario progression for learner engagement. It is a time-on-task plan that clearly defines the content areas for the experiential learning teaching strategy and specifies how learning will be assessed.
- Dialogue and conversation: Dialogue is a conversation. When we hold this lens, we shift from reading to or telling our learners what they need to know to the role of cognitive detective (Forneris & Fey, 2020). In this role, the educator’s goal is to understand how the learner makes sense of information or a situation. This creates an opportunity to ask open-ended questions that invite the teaching strategy of engaging metacognition – or thinking about our thinking.
As educators, our goal is to help learners examine their thinking, including what is guiding their thinking and how they put the pieces together, but how can we do that? Here is one approach. Restate what you heard the learner say. Then share your perspective. Then ask a question that helps refocus the learner’s thinking. For example, “I heard you say that you shouldn’t give a loop diuretic to a patient with low potassium because it has the potential to lower the potassium further. I’m thinking you are spot on. Tell me more about how you understand that connection between potassium and Lasix.” It is through examination of the learner’s thought processes that we can accurately diagnose learning needs. Similar to debriefing in simulation, we engage in high-level conversation that is easily transferrable to any learning encounter. It comes down to student-centered conversation.
When we think of our time with our learners as learning encounters, we embrace a student-centered approach to our teaching and learning.
- Begin with the end in mind. What are the outcomes for that learning encounter? Have a plan.
- Be transparent with your learners about your expectations for the learning encounter so that they have a sense of the boundaries and feel secure in fully engaging in the encounter.
- Engage learners in dialogue. Bring conversation to the encounter to understand how learners are using the content and if they are making the correct links.
Forneris, S.G., & Fey, M. (Eds.) (2020). Critical conversations (Volume 2): From monologue to dialogue. National League for Nursing.