Leigh Davis And Moira Cordiner 2008
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Leigh Davis And Moira Cordiner 2008



Session A - H6-09

Session A - H6-09



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Leigh Davis And Moira Cordiner 2008 Leigh Davis And Moira Cordiner 2008 Presentation Transcript

  • Not Another Essay! Transforming assessment in an evidence-based practice nursing unit Dr Leigh Davis Ms Moira Cordiner
  • Session Overview
    • Describe the process we used to design and deliver the first iteration of an EBP curriculum
    • Present the first iteration of the curriculum with students’ and teachers’ evaluations
    • Suggest implications to inform future iterations so that the effectiveness of the curriculum is improved .
  • What is Evidence Based Practice?
    • Is about making clinical decisions “on the basis of the best available scientific evidence but recognizing patient preferences , the context of healthcare and the judgment of the clinician.”
    • Pearson, A., et al., The JBI model of evidence-based healthcare. International Journal of Evidenced Based Healthcare, 2005. 3 : p. 207-215.
  • Why the move to Evidence Based Practice (EBP)?
    • Increasing volumes of health care research.
    • Rising health care expenditure
    • Health care professionals are accountable for their own practice
    • Consumers are becoming more informed
    • Reduce the variation in practice decisions
    • Important to healthcare quality assurance processes and accreditation
  • A model for Evidence Based Practice
    • Translation of uncertainty to an answerable question
    • Systematic retrieval of best evidence available
    • Critical appraisal of evidence for validity, clinical relevance, and applicability
    • Application of results in practice
      • Incorporation of evidence into hospital policies, guidelines
      • Using evidence in our everyday practice
    • Evaluation
  • EBP and University Curricula
    • Universities have begun to incorporate EBP in undergraduate healthcare degrees
    • No evidence to design or evaluate an EBP undergraduate nursing curriculum
    • Ciliska, D. (2005). Educating for Evidence-Based Practice. Journal of Professional Nursing 21 , (6), (pp345-350)
  • Implementation of first iteration
    • Team: discipline expert + academic staff developer
    • 3 steps:
    • Understand cohort characteristics
    • Design a major assessment task – ‘not another essay’
    • Scaffold students’ learning
  • Excerpt of the clinical scenario
    • You are a newly registered nurse working at Matilda Memorial country hospital. 
    • A 3 year old child with no known pre-existing medical conditions is admitted to the hospital with fever of unknown origin for investigation. 
    • Nurses at the hospital manage uncomplicated fever differently.
    • The hospital’s Director of Nursing has asked you to:
      • identify the best available evidence on the nursing management of uncomplicated fever in children
      • propose a draft policy based on the information you find.
  • Evaluation of first iteration
    • Three sources of data:
    • University-wide voluntary student evaluation of the unit (quantitative and qualitative data)
    • anecdotal information from students and tutors
    • the means of students grades/marks for the worksheet and the major task
  • Evaluation (cont) Feature of the unit % satisfied/very satisfied (N=194) Assessment: Level of difficulty 62% Assessment - Relevance to Topic 72% Relevance of the tutorial sessions 72% Written Assessment Mean Worksheet 15 marks 10.9 Major Essay “ Submission for a practice change” 50 marks 34
  • Limitations
    • 1. Problems with the first data source (QUT student evaluation of unit)
    • not from a randomised sample of students from the unit
    • we have no input into the generic construction of the survey.
    • survey administered by the university three weeks before students have submitted the major task or sat for their exam
    • small number of comments (44) - qualitative data is not representative.
    • 2. University policy prevents us from:
    • matching characteristics of particular students to the feedback they give us
    • obtaining details about the cohort, e.g. percentages who were mature-aged; the tertiary entrance scores of students who started the degree directly from high school, and the ratios of ESL students
  • What did the data indicate?
    • most students found the subject relevant and could achieve reasonable results in the assessment tasks
    • only 62% found the difficulty level satisfactory, despite the fact that the subject was at an introductory level
    • diverse and opposing opinions about the unit’s relevance, difficulty, challenge of major task, placement of the unit in the degree
    • many students ‘ described ’ rather than analysed and synthesised research information
    • failure rate not high – comparable to other units
  • Main problem: insufficient alignment
    • construct validity not as high as intended
    • authentic task but
    • construct validity compromised by insufficient authentic learning of EBP skills before applying them in the worksheet and major task
  • Conclusions
    • change the pedagogy in tutorials to provide more
      • scaffolding
      • practice of analysis and synthesis skills
      • reinforcement and feedback ( Caldwell, 2007 )
    • remove the requirement for students to produce a ‘policy document’ as part of the major task –is too challenging
  • Reflection
    • transformed some students views about assessment
    • underestimated the amount of practice third year students needed to develop analysis and synthesis skills
    • believe that EBP should be incorporated into all units and not be offered as a standalone unit