This document summarizes a presentation on active learning and increasing faculty-student interaction. It discusses how active learning is supported by brain research and provides practical examples of active learning strategies. These strategies include case studies, clinical scenarios, and reflective activities. The presenters also discuss outcomes from a study showing that increasing faculty interaction through activities like active learning and reduced threats led to improved student outcomes like higher grades and fewer failures.

1. Active learning: Moving the Student
from Theory to Application
Madelyn Danner, RN, MS, CNE
Sonia Galvan, RN, MS, CNE
Harford Community College
Session 6.1: January 6, 2017
sgalvan@Harford.edu

2. Objectives
• Summarize the ways in which active learning
is supported by brain-based research
• Provide an overview of practical ways to
increase faculty-student interaction using
specific examples of active learning.
• Present outcomes analysis of increasing
faculty-student interaction in a medical-
surgical course

3. Summary
Today we will provide some background on the
rationale for active and situated learning and
then give examples of what we do in our
courses. Sonia will provide data from her
assessment project which supports the impact
of this style of teaching on student learning
outcomes.

4. Why Active Learning?
• Assignments and tests provide an isolated
snapshot of learning on an isolated topic; active
learning provides ongoing assessment
• Active learning helps the learner form schemas
in long term memory.
• Active learning moves the focus from teacher
centric to student centric learning

5. The head and the heart
• Active learning by its very nature increases faculty-
student interaction
• Benefits reach beyond the cognitive domain, to the
affective domain
• Aspects that were isolated: Decreasing anxiety,
Increasing student’s sense of connectedness.
Increased understanding of relationship between
effort and reward

6. Why Experiential Learning?
• Students become practitioners of the role
they aspire to.
• Practice is essential to skill development.
• Students gain time to reflect on what they are
learning.

7. Concept: Students construct new knowledge & skills
based on current knowledge
• Link new knowledge to prior learning
• Link current learning to the bigger picture of course
or program outcomes
• Learning in context matters: Opportunities to
practice what they are learning helps them to
integrate this new knowledge with prior knowledge,
advancing schema formation and increasing retrieval
in the clinical practice setting

8. You’re the nurse……
Tell me about postop care for this client that you
already know to do

9. Concept: Beginning practitioners need more structure
and cues to build knowledge; more advanced learners
benefit from less cues.
• Move from cued questions to open ended
questions
– Low level learners need more structure, but as they advance they
benefit from less structure that requires deep thinking. Teaching
advanced learners like beginning learners actually led to less learning
and is called the “expertise reversal effect”. Recommended to fade
out cues as learners progress.
– This can be done over the course of the program, but also from the
beginning to the end of the course. This fade out seems to motivate
life long learning since the learners have to
generate the knowledge.

10. Clinical Scenario
• Theresa is a 62 year old
client who enters the
hospital for elective
knee replacement
surgery. Two days post
op she is receiving pain
medication and doing
physical therapy. She
develops a temperature
of 102.7. What else will
you assess?
• Later on:
• WBC is 16. What does
this mean?
• Neutrophils are high.
What does this mean?
• Banded neutrophils are
high. What does this
mean?

11. Peer Guided Scenarios
• Respiratory “standardized patients”
• Played by classmates who are prepared with
clinical scenarios
• Facilitated by instructor
• Again, cued questioning—classmates want
each other to succeed
• Increases interaction

12. You’re the nurse……
The client with epistaxis
comes to the ED with his
head tilted back and he is
pinching his nose. His BP is
180/98 & HR 98. What will
the nurse do first?
1. Recheck vital signs
2. Apply pressure and ice to
the nasal bridge
3. Reposition the airway
4. Draw blood for INR
The nurse tech calls the nurse
to report that the patient
with cirrhosis has vomited a
large amount of blood. What
steps does the nurse need to
take after going to the room?

13. Concept: Deliberate practice with feedback is
required for mastery
• Feedback with correction improves knowledge and
skill
• Ask questions at an application or higher level: recall
does not develop thinking
• “Real world” tasks cognitively engage for deeper
learning.
• Ask questions that require more than a memorized
response. Recall does not develop thinking.

14. You’re the nurse….
The nurse receives a call from the lab stating
they are reporting a “critical value”: Mrs. R’s
K is 2.8. How does the nurse respond?
• Students cannot take orders from providers, so they never get
to make these type of phone calls. Yet as soon as they are RNs
they are supposed to do this competently.
• This practice report to the doctor happens in case studies and
simulation clinical throughout the semester to help ease that
transition to practice.

15. Concept: Students need practice to pick out
what is important in a situation
• Students struggle to identify priorities
– They sit at the computer for an hour after report
trying to read everything in the chart, then go get
meds, then get to their first patient at 9A by which
time the patient has left the floor. They want to
weigh the patient before starting the IV fluids
needed to correct dehydration.

16. Case Study
HW is a 74 year old male admitted 5 days ago for dyspnea, chest pain, CHF, and
pleural effusion. The effusion was tapped 2 days ago and they drained 1500cc of
alcohol-like fluid. His PMH is significant for CAD, CHF, hypertension, CVA, diabetes,
renal dysfunction, asbestosis, & neuropathy. He is A&O. He’s been off O2 since
last night; his last SPO2 was 94%. Lungs clear and diminished. 2+ edema. SR with a
first degree block in the 90’s and occasional PVCs. Pulse palpable. Weighed 169
this morning. Abdomen soft with hypoactive BS. Having yellow watery foul
stools; had to clean him up twice last night. No added salt diet. Supposed to be on
a 2000cc fluid restriction but his family keeps bringing him in
sodas and food from home. Voided 150cc last
shift. ML in RFA is patent.

17. Questions For The Student
• Is there any data missing from report? What
are some questions you would want to ask the
nurse giving report? What data from report is
most clinically significant to you? What are
nursing problems you identify for Mr HW?
What are your 2-3 priority problems for the
day? What are your first actions after
receiving report?

18. Concept: Reflection is essential to
understanding an experience
• Lecture in a format that stimulates students to
imagine using this knowledge in practice
• Guide students to reflect on why they chose
an answer/course of action to increase
understanding

19. Concept: Give students authentic, real world
tasks to cognitively engage them
• Students need practice to become fluent at
reading situations and making an appropriate
response
• Students need practice making judgments in
situations which are “messy”

20. Brain Injury Case Study
Your morning assessment at 8:00 AM:
SC wakens to light shaking. You observe a golf ball size
hematoma to right frontal area and a bruise to right
temporal area. PERL. Oriented to person & place but
not time. Reports headache and nausea. Denies chest
pain. Lungs clear. VS at 7A per tech report 130/68, HR
80, RR 20, SPO2 97% on RA.
What is your analysis of this assessment data?
What is your nursing care plan for this
patient at this time?

21. Concept: Brains learn best through multi-
sensory environments
• Use multi-modal instructional techniques

22. Story & Film
• Students watch a clip from a Scrubs episode,
“My Cabbage” and discuss how the chain of
infection works.
• A patient’s mother tells a story (filmed) about
nursing assessment error and students discuss
recognizing the signs of shock
• Debriefing is essential for making the
connections—interaction!

23. Concept: Learning is enhanced by challenge and
inhibited by threat
• Lower perceived threat by relationship-
building
– 1:1 time with students in clinical. Care plans now due the
same day instead of the next week so that they became
real time, not theoretical plans. Problem list due in the
morning; care plan reviewed after lunch for feedback;
turned in at the end of the day. Encouraged to use online
resources or to ask faculty. Allows 1:1 time with faculty in
clinical which we didn’t have before.

24. Pre-Clinical Critical Thinking Evaluation
RM is a 22 year old who presents for care, telling you he
has a history of asthma and has been having difficulty
breathing for the past 6 hours. He has used his rescue
inhalers 10 times during this period and feels it has not
helped.
1. In what order will you implement these actions?
__position in high fowler’s
__obtain stat ABG’s
__administer a bronchodilator nebulizer treatment
__apply cardiac and oxygen monitors
__apply oxygen at 2-4L nasal cannula

25. You’re the nurse……
LS is a 31 y.o. child care worker who comes to the clinic c/o
weakness, fatigue, and weight loss. When leaning over to
pick up an infant, she became dizzy and almost dropped the
baby. She also reports loss of appetite, losing about 20 lbs.
in the past month, and nausea. The RN notes VS of 98/60
with HR of 108. Skin turgor is poor with tenting. Lungs are
clear to auscultation. Addison’s disease is suspected.
Relate LS’s sxs to her loss of adrenal hormones
This is a think-pair-share exercise that helps
build relationships with peers for
teamwork.

26. Why Increase Interaction?
• Literature linked to success
–Both 2 year and 4 year colleges
–Connected to motivation & engagement
–Predictor of persistence
• Trust essential for learning to take place
• Reduces anxiety
• Increases self-efficacy

27. The Literature
• This concept of increasing faculty-student interaction ties into
many of the concepts Madelyn has just discussed, but the
recent one most of all: reducing threat in learning. Original
work--also more recent studies as well as the seminal ones
support the benefits of faculty-student interaction.
• IN FACT……Faculty-student interaction appears to have a
greater effect on self-perception of learning than minority
status, socioeconomic status, part-time enrollment status, and
gender--all of which do significantly impact self-perception of
learning

28. Support Learning Through
Relationships
• The literature says:
–Creates teacher immediacy
–Creates a warm environment
–Increases accessibility
–Reduces anxiety

29. Create Warmth With Intent
• Breaking the ice
–“Common and Different”
–SBAR Your Car
–“Choose 3 Things”
• Quick feedback—informal polling cards, exit
slips
• Presence—arrive early, stay late
for classes

30. Researching Faculty-Student
Interaction
• Goal: Increase student success in
beginning medical-surgical nursing course
• Literature analysis : increasing faculty-
student interaction could have a positive
effect on outcomes (National Survey of
Student Engagement [NSSE], 2012, 2014)

31. Interventions
• Inside classroom (most powerful)
• New course orientation
• Increased active learning to 30%
• “Office hours” in the classroom
• Outside classroom
• Improved accessibility of office hours
• Increased email contact
• Reaching out for
remediation

32. Outcomes Analysis
• 6 semesters, 419 students (210 before, 209
after)
• Mean average increased 1.4 points after
interventions
• 21 (before) vs. 11 (after) theory failures
• T-test showed difference was statistically
significant

33. Other Variables
• Age—no significant differences
• Gender—no significant differences
(applied chi-square test for
independence of variables)
• GPA—higher in the pre-intervention
group (3.40 vs. 3.30)

34. Conclusion
• Interaction matters—a lot!
• Changes were small
– Did require planning
• Workload increased minimally
– Office hour time actually went down
• Evaluations improved substantially
• Learning improved