Promoting the SBAR Communication Tool with Nursing Students

Promoting the SBAR Communication Tool with Nursing Students

Konstantina Caris

New York City College of Technology/Nursing

NUR-1110/Caring for Clients with Common Alterations in Functional Needs

Activity Description: Provide a brief description of the activity

Knowing that patient handover is often poorly performed, with critical detail being omitted and irrelevant information included at patient handoff this activity stresses on implementing the use of the ISBAR tool with nursing students during clinicals. SBAR stands for situation (clearly and briefly describe the current patient’s situation), background (provide clear, relevant background information on the patient), assessment (state your professional conclusion, based on the situation and background), and recommendation (telling the person with whom you’re communicating what would you recommend correcting the problem).

This format ensures clinicians communicating significant information in continuity of patient care, preventing errors and harm in hospital settings or community settings. It provides a standardized approach to communication which is a core skill that needs to be taught to nursing students and junior clinicians. It highlights key elements and explores teaching techniques that aim to ensure the framework is rooted in practice effectively resulting in patient’s safety and better patient outcomes.

Learning Goals: What do you aim to achieve with this activity?

The goal of this activity is to develop the student’s critical thinking and communication skills during patient’s handover by following the SBAR format. The need to assess, understand, analyze, prioritize patient health issues, and recommend solutions, is imperative among clinicians in healthcare. Communicating accurate patient information from team to team is an essential component of good patient care, effective management of the patient’s condition, and teamwork. However, critical thinking skills does not happen overnight. Students need to practice this format constantly during clinical rotations to enhance critical thinking and communication skills and at the same time prevent patient errors.

Timing: At what point in the lesson or semester do you use this activity? How much classroom time do you devote to it? How much out-of-class time is expected?

This activity was implemented step by step during clinical rotations the entire semester. For two weeks we devoted 60 minutes learning and understanding the importance of the SBAR tool and how it works.

Next, for four clinical days students practiced the format taking into consideration the information they obtained while caring and assessing assigned patients. Their report emphasized on the patient’s main problem, on communicating appropriate patient’s history, the right examination/observation, and creating a clear recommendation.

At midsemester, while each student gave report, the other students listen and observed. At post conference they had the opportunity to critique the report by asking questions, make suggestions, and reflect if the sequence of the SBAR format was followed. For example: “If the student highlighted key elements of effective clinical information”, “Did they give excess information or too little”, “How did they feel being the presenter as opposed to observer”, or “What they would have done differently and why”. This activity took between 30-45 minutes.

Logistics: What preparation is needed for this activity? What instructions do you give students? Is the activity low-stakes, high-stakes, or something else?

This is an ongoing interactive high stakes assignment where the instructor assigned a patient to the student to assess and care the entire clinical day. During this time the student must think critically when deciding what patient information should be communicated to other healthcare professionals according to their assessment, knowledge, analysis, problem solving, and reflection. Practicing the ISBAR format during nursing clinicals increases their capacity to share key information, be mindful of their role as well as their team members, enhance their confidence on patient assessments, and implement optimal patient interventions.

Assessment: How do you assess this activity? What assessment measures do you use? Do you use a VALUE rubric? If not, how did you develop your rubric? Is your course part of the college-wide general education assessment initiative?

High stakes assignment=level of engagement.
Students who observed as well as the instructor had to complete a four-point scale ranging “Not performed the SBAR format competently”, to “Able to perform format under minimal direction”. Student’s performance focused on “What is going on with the patient”, “ What was the patient’s clinical background or context”, “If appropriate assessment/observation was done”, and “ What would they recommend to correct the problem”.

Reflection: How well did this activity work in your classroom? Would you repeat it? Why or why not? What challenges did you encounter, and how did you address them? What, if anything, would you change? What did students seem to enjoy about the activity?

A continuous effort to stress the importance to communicate key elements of effective clinical handover emphasized during clinicals with nursing students. By following the use of the SBAR format during clinical, prepares them not only for the clinical demands of the job, but also focuses on their critical thinking and communication skills that are so important for improving patient outcomes and recognizing a decline in a patient’s condition. At the same time instructors can explore teaching techniques that aim to ensure the framework is embedded in practice effectively.

Involving students to learn a structured way to communicate relevant patient information to other healthcare professionals was challenging due to overwhelming nursing material they had to cover during their semester. However, at the end of their clinicals they expressed that the SBAR format helped them organize patient information in a structured way saving time. Prioritizing on what information should they handover was also challenging because they had to focus on what is going on currently and taking into consideration patient’s general health status.

Additional Information: Please share any additional comments and further documentation of the activity – e.g. assignment instructions, rubrics, examples of student work, etc. These can be links to pages or posts on the OpenLab.

SBAR

Situation-Background-Assessment-Recommendation

Example

Mr. Barnes is a 72 y/o admitted to the oncology unit yesterday for his 5th cycle of in-patient chemotherapy for gastric cancer. He has a fever of 102.5 F. He’s receiving a continuous 48-hour infusion of Oxaliplatin and 5-FU. other than the fever, his vital signs are all normal: BP 124/64, HR 62, RR16, O2 98%. He has no complaint of pain or discomfort, NKA. As the primary nurse you’re concerned about the fever and neutropenia. You would like and order for Tylenol, blood cultures, and a CBC.

Organized structured format for SBAR

Situation-Background-Assessment-Recommendation

S=This is Jane Doe, the primary nurse for Mr. Barnes, on the medical oncology unit. He is febrile, 102.5 F.

B- He was admitted yesterday for his 5th cycle of in-patient chemotherapy for gastric cancer. He’s receiving a continuous 48 hors infusion of Oxaliplatin and 5-FU. He has no known allergies.

A-Other than the fever, his vital signs are all normal: BP 124/64, HR 62, RR 16,02 98%. He has no complaint of pain or discomfort.

R- I am concerned about the fever and neutropenia, I recommend an order for Tylenol, blood cultures, and a CBC. Is there anything ales you would recommend at this time?

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Critical thinking

Critical thinking

Wenhsing Yang

City Tech

NUR 2110

Activity Description: Provide a brief description of the activity

Critical thinking through writing assignments-understand the patient care with their needs

Learning Goals: What do you aim to achieve with this activity?

familiar with priority, delegation, quality of care

Timing: At what point in the lesson or semester do you use this activity? How much classroom time do you devote to it? How much out-of-class time is expected?

I used half hours in class and lab for students to think about patient care and how to intervene with their needs.

Logistics: What preparation is needed for this activity? What instructions do you give students? Is the activity low-stakes, high-stakes, or something else?

students need to be familiar with the disease process and its influence to patients quality of life.
some are low-stakes, some are high-stakes, because it was being use in the simulation

Assessment: How do you assess this activity? What assessment measures do you use? Do you use a VALUE rubric? If not, how did you develop your rubric? Is your course part of the college-wide general education assessment initiative?

I use Gen. rubric.

Reflection: How well did this activity work in your classroom? Would you repeat it? Why or why not? What challenges did you encounter, and how did you address them? What, if anything, would you change? What did students seem to enjoy about the activity?

i will repeat it but I will use different scenarios because every patients is different

Additional Information: Please share any additional comments and further documentation of the activity – e.g. assignment instructions, rubrics, examples of student work, etc. These can be links to pages or posts on the OpenLab.

Please share a helpful link to a pages or post on the OpenLab

Critical thinking

Critical thinking

Wenhsing Yang (Annie)

Nursing

Nur 2110

Activity Description: Provide a brief description of the activity

You will be assigned to a group (4 to 5 students) and discuss this case study. This activity will take 30 minutes. After that, you have ten minutes to present your answer to the class. You will need to use textbooks and online resources to provide your answers and rationales. Feedback is welcome.

Learning Goals: What do you aim to achieve with this activity?

The goal of this assignment is based on ACEN requirement (critical thinking) as follow:
1.Goal is to avoid having your decision cause injury to anyone
2.With critical thinking skills, you can weight many factors and skillfully solve problems, making good decisions a majority of the time
3.Operating in critical thinking model while pursuing nursing studies helps develop clinical judgement needed to practice safe nursing
4.Nursing use a knowledge base to make decision, generate new ideas, and solve problems.

Timing: At what point in the lesson or semester do you use this activity? How much classroom time do you devote to it? How much out-of-class time is expected?

This assignment will be used at the end of the cancer chapter (week five).
This activity will take 30 minutes. After that, you will present your answer to the class.
This presentation will take 10 minutes per group.

Logistics: What preparation is needed for this activity? What instructions do you give students? Is the activity low-stakes, high-stakes, or something else?

I will need to create a scenario and questions for students to complete the assignment. You have 30 minutes to complete the assignment and present it to the class.
This is a group assignment; you will be assigned to a group to discuss your answer. Please note, you will need to provide evidence-based on your answer. Please feel free to use online resources and textbooks.
This is a low-stakes assignment because it does not cause danger to people. Instead, students have the opportunity to share the answers with the class and ask for feedback.

Assessment: How do you assess this activity? What assessment measures do you use? Do you use a VALUE rubric? If not, how did you develop your rubric? Is your course part of the college-wide general education assessment initiative?

I use the Value rubric -critical thinking. This is part of a college-wide general education assessment.

Reflection: How well did this activity work in your classroom? Would you repeat it? Why or why not? What challenges did you encounter, and how did you address them? What, if anything, would you change? What did students seem to enjoy about the activity?

Yes, I will repeat this activity with different classes. Different case studies will be provided based on the course objective and outcome.
Only a few students discuss in the class, so I will need to facilitate the activity and ask other students for their input.
I will give each group different case studies, so the students will have different understanding of each disease and their nursing interventions.
Students like to hear from other groups with their answers and rationales. Because each group has different answers based on their priority and information. Additionally, students will be able to work with other students. In nursing, teamwork is necessary.

Additional Information: Please share any additional comments and further documentation of the activity – e.g. assignment instructions, rubrics, examples of student work, etc. These can be links to pages or posts on the OpenLab.

N/A

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Chef Report Self Assessment

Chef Report Self Assessment

Jessie Riley

HMGT

Culinary 1

Activity Description: Provide a brief description of the activity

In Culinary 1 each week students are assigned different positions in the kitchen and complete a chef report the week after they have served as chef. This was a disposable assignment. I created as self assessment rubric and discussed the assignment with students each week. We discussed evaluating ones own work to back and forward.

Learning Goals: What do you aim to achieve with this activity?

To provide the students a safe environment to evaluate their performance over the 15 weeks of the semester.

Timing: At what point in the lesson or semester do you use this activity? How much classroom time do you devote to it? How much out-of-class time is expected?

It was described the first day and each week we would discuss the prior lesson and the up-coming lesson. In the class we devoted 15 minutes and outside of class it could take the students 20-40 minutes. to complete

Logistics: What preparation is needed for this activity? What instructions do you give students? Is the activity low-stakes, high-stakes, or something else?

I started to use open lab but had some difficulty so moved the assignment to Blackboard. It is a low stakes activity

Assessment: How do you assess this activity? What assessment measures do you use? Do you use a VALUE rubric? If not, how did you develop your rubric? Is your course part of the college-wide general education assessment initiative?

I modified an assessment rubric and provided students with a hard copy and a soft copy

Reflection: How well did this activity work in your classroom? Would you repeat it? Why or why not? What challenges did you encounter, and how did you address them? What, if anything, would you change? What did students seem to enjoy about the activity?

Yes, as this was the first time I believe it can be improved and I have discussed with the chair about having other instructors incorporate the assignment. The chef report is completed by students in 3 other courses so there is an opportunity to incorporate it into the student's portfolio

Additional Information: Please share any additional comments and further documentation of the activity – e.g. assignment instructions, rubrics, examples of student work, etc. These can be links to pages or posts on the OpenLab.

I will attach an excel work book and student assignments and the rubric in an email

Please share a helpful link to a pages or post on the OpenLab

Formulate Questions to Advance Learning and Understanding of Course Content

Formulate Questions to Advance Learning and Understanding of Course Content

Diana Zhu

Mathematics/NYCCT

MAT1375 Pre-Calculus

Activity Description: Provide a brief description of the activity

Weekly discussion boards will be set up for students to ask questions from the class. Students can view and answer them. I will post feedback for the class to see, and I will take one or two good questions to discuss when I see them in the next class.

Learning Goals: What do you aim to achieve with this activity?

I want to create a learning environment where students are welcomed to ask and answer questions comfortably. I want students to know that their questions are being valued, and that plays a big role in their learning. It gives students another view of learning Math is not just working on Math problems, but formulating questions outside class is a key for deeper understanding of the course content.

Timing: At what point in the lesson or semester do you use this activity? How much classroom time do you devote to it? How much out-of-class time is expected?

A week before the first day of class, I sent students an email to inform them about this discussion board. To get started, I asked them to write a post on the following questions: “What is your view on Math learning?” “How do you learn the best? Independently or in groups?” and “What are your expectations for this class?” I have a few reasons for giving them this: first, I get to know students before the first day. Second, it helps me design my classroom setting according to class topics. Third, I can track how many students have access to Blackboard.
During the first day of class, I would go over the Blackboard with students to get them familiar with it and informed them about the weekly discussion boards would be set up for discussion questions. I usually spent up to 20-30 mins on questions they were still confused after the discussions on Blackboard with their peers.
Outside of class, students are expected 10-30 mins on discussion board as posting a question or replying to their peers' questions. For students who did not have questions, I would also encourage them to share the problems they encountered or learned with their peers. For me, I would spend about 40-60 mins weekly as reviewing students' questions and see if they are anything that need to be clarified. I also gave them feedback when they replied to questions on discussion board. Also, sometimes I would send the class an email if what they shared on Blackboard would be beneficial to students before next class.

Logistics: What preparation is needed for this activity? What instructions do you give students? Is the activity low-stakes, high-stakes, or something else?

Students would need to take good notes and use notes to work on their homework assignments. Sometimes, students will have questions by reading notes or working on homework questions. I was very flexible with questions they had from the class, and I just posted the weekly discussion board after each class. Also, I would send them a gentle reminder along with class update. When students got busy with their high school assignments or exams, I would remind and ask them to post questions after they finished with them. I think this activity can be low stakes if students ask very basic questions. It can be high stakes if students want to generate a question that requires deeper thinking. Sometimes, students may not understand others' questions because they did not have a good understanding of the content that the question is focused on. In general, formulating a question can be harder than answering a question.

Assessment: How do you assess this activity? What assessment measures do you use? Do you use a VALUE rubric? If not, how did you develop your rubric? Is your course part of the college-wide general education assessment initiative?

I counted this activity part of students' participation grades. In addition, students' in-class participation weighs more, but I did not tell that to the students. In class, I tried to cold call every student to get them engaged; I would ask students to come to board to show their work. I created a simple rubric that focuses on "initiative", but I did not make full use of it. Some topics may only require students to apply formulas that did not really give students much confusion where I did not expect questions from them. Therefore, it can be hard for me to assign specific points weekly based on students' discussion questions on Blackboard. Instead, I combined students' in-class participation and their participation on discussion board to assign participation grades for each student.

Reflection: How well did this activity work in your classroom? Would you repeat it? Why or why not? What challenges did you encounter, and how did you address them? What, if anything, would you change? What did students seem to enjoy about the activity?

*Being the first time implementing such activity, I think it went well as students got used to questions in my class.
*I would like to think about alternative ways to help students initiate questions because towards the end, many students would just post their screenshots of questions that they have from assignments. My original intension was helping students to generate questions not simply solving Math problems, but general questions related to the topics.
*Some students had the misunderstanding that if they knew the materials then no need to post questions. I had to have a class conversation to students that even if they understood everything, they were required to answer others' questions or share what they learned from each other's questions and responses. A student talked to me in office that he felt no need to post a question because his confusion can be answered during office hour. I told the student that team/group work is so important not just in school but in future career. I told the student about my expectations for him to share what he asked and learned from office hour to his peers, and he did. I think I would like to have a sheet of specific weekly discussion questions ready for future students and leave a question for students to write one. I think this way, I can check students for understanding and I can use students' common and meaningful questions for in-class discussions. This prevents the problem as no questions being posted on Blackboard occasionally.
*Students enjoyed the activity when they missed a class because they can ask each other questions on discussion boards. When they answered each other's questions, they also tried to be as specific as possible which made me very proud of. They did not rush to just giving out answers but explaining their work.

Additional Information: Please share any additional comments and further documentation of the activity – e.g. assignment instructions, rubrics, examples of student work, etc. These can be links to pages or posts on the OpenLab.

I only used the OpenLab to share the reflection because I could not attach it here. I finally found a way to make the file onto OpenLab with tables shown. Overall, it was a great learning experience for me. Without attending the workshop, I could never come up with discussion board idea for my class to help students form the habit of generating questions and share with their peers. Very appreciate this opportunity.

Please share a helpful link to a pages or post on the OpenLab

https://openlab.citytech.cuny.edu/mat1375cn05/reflection-on-discussion-boards/

How strong you should hit a ball to break a glass?

Adjunct Assistant Professor

Viktor Boiko

Physics

General Physics I (Phys 1433, Phys 1441)

Activity Description: Provide a brief description of the activity

The Project is based on the work of Pyotr Kapitsa, who was famous physicist and Nobel laureate. (https://en.wikipedia.org/wiki/Pyotr_Kapitsa)
He published book “Problems in Physics”, which include problems for discussion. These problems did not give all conditions and details for a solution, so a student can choose them.
One of such problem is: “What must be the speed of a tennis ball that can break glass?”
I modified a little bit this problem and student should find an answer on a question “How strong you should hit a ball to break a glass?” (What force should be applied)
To find an answer students should use all Physics laws and principles from a semester (Physics I) and to choose all conditions what they need for the solution.

Learning Goals: What do you aim to achieve with this activity?

What should student use during the project:
Physics
Imagination
Abstract and critical thinking
Understand how and which questions to ask
Basics of engineering design
Analytical thinking and mathematical calculations
Technical/report writing
Backward thinking
Calculation in a new soft/web program
Working with data
Working in a group

Timing: At what point in the lesson or semester do you use this activity? How much classroom time do you devote to it? How much out-of-class time is expected?

This project is one thirds of a semester. Students should do it at home. All steps would be describe during class time and all questions would be discussed in a class.

Logistics: What preparation is needed for this activity? What instructions do you give students? Is the activity low-stakes, high-stakes, or something else?

Students will have step by step instructions for this project.

Assessment: How do you assess this activity? What assessment measures do you use? Do you use a VALUE rubric? If not, how did you develop your rubric? Is your course part of the college-wide general education assessment initiative?

CRITICAL THINKING VALUE RUBRIC, PROBLEM SOLVING VALUE RUBRIC, WRITTEN COMMUNICATION VALUE RUBRIC, READING VALUE RUBRIC, CREATIVE THINKING VALUE RUBRIC (Project with wide borders for advance level of the course)

Reflection: How well did this activity work in your classroom? Would you repeat it? Why or why not? What challenges did you encounter, and how did you address them? What, if anything, would you change? What did students seem to enjoy about the activity?

Student are interested in the project, they ask a lot of questions. The assignment requires a good level of knowledge and some students have difficulties. In this case more time for a discussion should be during a class.

Additional Information: Please share any additional comments and further documentation of the activity – e.g. assignment instructions, rubrics, examples of student work, etc. These can be links to pages or posts on the OpenLab.

Please share a helpful link to a pages or post on the OpenLab

Programming in Python

Programming in Python

Marius Constantin

CET

EMT 1111

Activity Description: Provide a brief description of the activity

In the midst of the challenges we went through this Spring semester, I decided to address the priorities of general education using some critical and innovating teaching strategies, such as collaborative assignments and projects on OpenLab, ePortfolios, open educational resources to further engage my students in the new academic context.

Learning Goals: What do you aim to achieve with this activity?

Research has shown that online learning is generally less effective than face-to-face interaction and that students who are already struggling are likely to be harmed the most.
My goal is to compensate the drawbacks of remote instruction: self-discipline, time management, anxiety and depression due to isolation.

Timing: At what point in the lesson or semester do you use this activity? How much classroom time do you devote to it? How much out-of-class time is expected?

The entire semester.

Logistics: What preparation is needed for this activity? What instructions do you give students? Is the activity low-stakes, high-stakes, or something else?

In terms of high impact educational practices, I will consider collaborative assignments and projects and ePortfolios. While I will continue to request that each homework assignment to be completed and submitted individually, multiple attempts are allowed and the highest grade to be recorded. At the end of the semester, a final project in a form of a computer program will be assigned to 4 groups of students, and each student needs to have his/her collaborative share. This final project will weight 30% of the final grade for each student in the group and needs to be posted on OpenLab.

Assessment: How do you assess this activity? What assessment measures do you use? Do you use a VALUE rubric? If not, how did you develop your rubric? Is your course part of the college-wide general education assessment initiative?

Inquiry and Analysis is the rubric I chose to assess the students’ needs. For a proper inquiry I need to identify what doesn’t work for them and then analyze these findings by chunking down information into smaller parts, or from abstract to more specific concepts for a better understanding.

Reflection: How well did this activity work in your classroom? Would you repeat it? Why or why not? What challenges did you encounter, and how did you address them? What, if anything, would you change? What did students seem to enjoy about the activity?

To compensate for the lack of physical presence I will continue to provide, and even improve, a supportive learning environment where all students feel comfortable participating.
Attendance was the foremost concern, followed by internet connectivity issues.

Additional Information: Please share any additional comments and further documentation of the activity – e.g. assignment instructions, rubrics, examples of student work, etc. These can be links to pages or posts on the OpenLab.

I shall continue to use My Programming Lab, a excellent cloud-based tool, for the following reasons:
a. it provides a personalized learning experience that improves results for each student;
b. it contains a set of programming exercises correlated with the textbook that are focused on
a particular topic;
c. the feedback offered to students helps them master the syntax, semantics and basic usage
of Python programming language;
d. autonomous practice, where the feedback provided allows students to easily identify both compiling and logic errors in their code.

Please share a helpful link to a pages or post on the OpenLab