Not Another Essay! Transforming assessment in an evidence-based practice nursing unit Dr Leigh Davis Ms Moira Cordiner
Session Overview <ul><li>Describe the process we used to design and deliver the first iteration of an EBP curriculum  </li...
What is Evidence Based Practice? <ul><li>Is about making clinical decisions “on the basis of the best available   scientif...
Why the move to Evidence Based Practice (EBP)? <ul><li>Increasing volumes of health care research.  </li></ul><ul><li>Risi...
A model for Evidence Based Practice <ul><li>Translation of uncertainty to an answerable question  </li></ul><ul><li>System...
EBP and University Curricula <ul><li>Universities have begun to incorporate EBP in undergraduate healthcare degrees </li><...
Implementation of first iteration <ul><li>Team: discipline expert + academic staff developer </li></ul><ul><li>3 steps: </...
Excerpt of the clinical scenario <ul><li>You are a newly registered nurse working at Matilda Memorial country hospital.   ...
Evaluation of first iteration <ul><li>Three sources of data:  </li></ul><ul><li>University-wide voluntary student evaluati...
Evaluation  (cont) Feature of the unit % satisfied/very satisfied (N=194) Assessment: Level of difficulty 62% Assessment -...
Limitations <ul><li>1. Problems  with the first data source (QUT student evaluation of unit) </li></ul><ul><li>not from a ...
What did the data indicate? <ul><li>most students found the subject  relevant  and could  achieve  reasonable results in t...
Main problem: insufficient alignment <ul><li>construct validity not as high as intended </li></ul><ul><li>authentic task b...
Conclusions <ul><li>change the pedagogy in tutorials to provide  more </li></ul><ul><ul><li>scaffolding </li></ul></ul><ul...
Reflection <ul><li>transformed some students views about assessment </li></ul><ul><li>underestimated the amount of practic...
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Leigh Davis And Moira Cordiner 2008

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Session A - H6-09

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Leigh Davis And Moira Cordiner 2008

  1. 1. Not Another Essay! Transforming assessment in an evidence-based practice nursing unit Dr Leigh Davis Ms Moira Cordiner
  2. 2. Session Overview <ul><li>Describe the process we used to design and deliver the first iteration of an EBP curriculum </li></ul><ul><li>Present the first iteration of the curriculum with students’ and teachers’ evaluations </li></ul><ul><li>Suggest implications to inform future iterations so that the effectiveness of the curriculum is improved . </li></ul>
  3. 3. What is Evidence Based Practice? <ul><li>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.” </li></ul><ul><li>Pearson, A., et al., The JBI model of evidence-based healthcare. International Journal of Evidenced Based Healthcare, 2005. 3 : p. 207-215. </li></ul>
  4. 4. Why the move to Evidence Based Practice (EBP)? <ul><li>Increasing volumes of health care research. </li></ul><ul><li>Rising health care expenditure </li></ul><ul><li>Health care professionals are accountable for their own practice </li></ul><ul><li>Consumers are becoming more informed </li></ul><ul><li>Reduce the variation in practice decisions </li></ul><ul><li>Important to healthcare quality assurance processes and accreditation </li></ul>
  5. 5. A model for Evidence Based Practice <ul><li>Translation of uncertainty to an answerable question </li></ul><ul><li>Systematic retrieval of best evidence available </li></ul><ul><li>Critical appraisal of evidence for validity, clinical relevance, and applicability </li></ul><ul><li>Application of results in practice </li></ul><ul><ul><li>Incorporation of evidence into hospital policies, guidelines </li></ul></ul><ul><ul><li>Using evidence in our everyday practice </li></ul></ul><ul><li>Evaluation </li></ul>
  6. 6. EBP and University Curricula <ul><li>Universities have begun to incorporate EBP in undergraduate healthcare degrees </li></ul><ul><li>No evidence to design or evaluate an EBP undergraduate nursing curriculum </li></ul><ul><li>Ciliska, D. (2005). Educating for Evidence-Based Practice. Journal of Professional Nursing 21 , (6), (pp345-350) </li></ul>
  7. 7. Implementation of first iteration <ul><li>Team: discipline expert + academic staff developer </li></ul><ul><li>3 steps: </li></ul><ul><li>Understand cohort characteristics </li></ul><ul><li>Design a major assessment task – ‘not another essay’ </li></ul><ul><li>Scaffold students’ learning </li></ul>
  8. 8. Excerpt of the clinical scenario <ul><li>You are a newly registered nurse working at Matilda Memorial country hospital.  </li></ul><ul><li>A 3 year old child with no known pre-existing medical conditions is admitted to the hospital with fever of unknown origin for investigation.  </li></ul><ul><li>Nurses at the hospital manage uncomplicated fever differently. </li></ul><ul><li>The hospital’s Director of Nursing has asked you to: </li></ul><ul><ul><li>identify the best available evidence on the nursing management of uncomplicated fever in children </li></ul></ul><ul><ul><li>propose a draft policy based on the information you find. </li></ul></ul>
  9. 9. Evaluation of first iteration <ul><li>Three sources of data: </li></ul><ul><li>University-wide voluntary student evaluation of the unit (quantitative and qualitative data) </li></ul><ul><li>anecdotal information from students and tutors </li></ul><ul><li>the means of students grades/marks for the worksheet and the major task </li></ul>
  10. 10. 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
  11. 11. Limitations <ul><li>1. Problems with the first data source (QUT student evaluation of unit) </li></ul><ul><li>not from a randomised sample of students from the unit </li></ul><ul><li>we have no input into the generic construction of the survey. </li></ul><ul><li>survey administered by the university three weeks before students have submitted the major task or sat for their exam </li></ul><ul><li>small number of comments (44) - qualitative data is not representative. </li></ul><ul><li>2. University policy prevents us from: </li></ul><ul><li>matching characteristics of particular students to the feedback they give us </li></ul><ul><li>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 </li></ul>
  12. 12. What did the data indicate? <ul><li>most students found the subject relevant and could achieve reasonable results in the assessment tasks </li></ul><ul><li>only 62% found the difficulty level satisfactory, despite the fact that the subject was at an introductory level </li></ul><ul><li>diverse and opposing opinions about the unit’s relevance, difficulty, challenge of major task, placement of the unit in the degree </li></ul><ul><li>many students ‘ described ’ rather than analysed and synthesised research information </li></ul><ul><li>failure rate not high – comparable to other units </li></ul>
  13. 13. Main problem: insufficient alignment <ul><li>construct validity not as high as intended </li></ul><ul><li>authentic task but </li></ul><ul><li>construct validity compromised by insufficient authentic learning of EBP skills before applying them in the worksheet and major task </li></ul>
  14. 14. Conclusions <ul><li>change the pedagogy in tutorials to provide more </li></ul><ul><ul><li>scaffolding </li></ul></ul><ul><ul><li>practice of analysis and synthesis skills </li></ul></ul><ul><ul><li>reinforcement and feedback ( Caldwell, 2007 ) </li></ul></ul><ul><li>remove the requirement for students to produce a ‘policy document’ as part of the major task –is too challenging </li></ul>
  15. 15. Reflection <ul><li>transformed some students views about assessment </li></ul><ul><li>underestimated the amount of practice third year students needed to develop analysis and synthesis skills </li></ul><ul><li>believe that EBP should be incorporated into all units and not be offered as a standalone unit </li></ul>

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