3 ways to improve nursing student learning outcomes

When it comes to gauging success of a school's nursing program, one of the key areas of focus is nursing program outcomes. How are your students performing on the NCLEX exam? What are their class grades? How well are they doing in other key performance indicators in the classroom?

Concept-based learning is a way to vastly improve nursing programs outcomes; it enables the learner to take an energetic and engaged role in their own education and provides active learning environments that help students learn, retain and later, use, the information they are taking in.

What concept-based learning can do for your nursing program outcomes

Good nurse educators are always searching for the best ways to prepare new nurses to solve problems and think critically in order to provide high-quality care to patients. And nurses must be able to work collaboratively, analyze data, interpret results, think critically, draw reasoned conclusions and make complex decisions.

The traditional (content-based) teaching method involves a teacher-centered approach in which the nursing education faculty teach, and nursing students listen - and, hopefully, retain the information and learn from it. This method doesn't necessarily encourage critical thinking in students, and they typically rely on rote memory rather than careful understanding of the issues.

But concept-based learning gets the students engaged in the lessons and makes them active participants in the learning process. Concept-based learning focuses on a finite number of concepts, enabling the student to get the big picture (the key ideas). Students then use exemplars to fill in and understand the processes more thoroughly.

Concept-based learning gives students opportunities to deliberate plausible solutions to real-life situations and nursing challenges in an active learning setting. This teaching method works well in conjunction with other active learning strategies that engage students and generally make learning more enjoyable, motivational and effective.

Other benefits of concept-based learning include:

1. Helps students take a more active role in their learning using the “flipped classroom model of instruction.
2. Streamlines content and eliminates content redundancies across courses.
3. Enables faculty to teach clinical reasoning skills more easily.
4. Helps students apply concepts from one situation to another and make connections between those concepts.
5. Encourages students to see patterns across concepts and use those patterns to deliver care and anticipate risks.

All of this leads to higher retention rates, test performance and success in the future workplace.

3 Proven strategies to boost your nursing program outcomes

Dr. Tola Plusnick, Associate Director of the ADN program at Weatherford College in Texas, which successfully adopted a concept-based curriculum and immediately saw results, offers up three proven strategies to bring concepts to the bedside during clinical practice. These strategies will help improve your nursing students” learning outcomes:

1. “Concept Day"

“Concept Day is an activity used in place of traditional clinical practice.

Prior to the designated clinical day, students are given pre-work to read and think about. They should have prior knowledge of the objective and subjective assessment necessary for the concept. Students should also know the diagnosis related to the concept and how to interpret the results.

Pre-conference is led by the students who discuss the concept. Ensure that all students understand the concept and the exemplar. Divide students into pairs or small groups; two to three students per group is ideal for true engagement. Have each group review a set number of patient electronic charts, looking for evidence of the concept. Students have a set amount of time to go through the charts. Then, call them back together and discuss each patient and what the students expect to find when they actually assess the patient.

Each group of students then assesses the patient, looking for evidence of a disruption of the concept. Were the findings what students expected? If so, how; and if they weren't, why? Was the concept truly disrupted?

Apply the nursing process to each patient by developing a priority problem, a goal, interventions with evidence-based rationale, and evaluation criteria.

When the students are finished, debrief the entire experience, focusing on the concept rather than the medical diagnosis.

*Tip: Instructor should visit each patient prior to the group of students entering the patient's room. If the patient is on board, it eases the way for students.

2. Concept observations

Concept observations can enhance the traditional clinical experience. Here's how it works:

Identify a focus concept. Then have students identify examples of this concept they observed during the clinical day. Provide time for students to research the concept more.

Students present the concept, research, their observations of the concept in action, and evaluation of best practices. They talk about what should be done, how it was observed, and the ramifications of the actions taken. This activity provides meaningful activity during the day without much student down time.

3. Concept analysis

A concept analysis document is used for clinical paperwork; two pages in particular help bring concepts into the clinical program each day. Here are some sample pages:

Students make assessments based on information gained from charts and from speaking with the patients. “We want the student to give us a history of the present illness, the story of how the patient ended up in the hospital," Plusnick says.

Primary medical diagnosis comes from the chart. Why is the patient here? What in this patient's history made him/her susceptible to this disease? The primary conceptual problem gives the student practice determining under which concept this diagnosis fits. Students must truly understand the disease process in order to make a medical diagnosis.

Next, students brainstorm everything that could be going on with this patient - manifestations, labs, psychosocial, etc. Each problem is then related to a specific concept. They then choose the top three prioritized problems.

Problem #1 Analysis

Students transfer information from the document's first page using parts and pieces related to their priority #1 problem.

Students must now come up with a goal. Short-term goals are determined for the student's shift, while long-term goals address anything beyond the student's shift.

The Plan of Care section deals with the Interventions needed to meet those goals. Positive and negative outcomes must be related to the concepts. Positive outcomes must address how the student knows the chosen concept is working. Negative outcomes address how they know if the intervention is not working.

The Evaluation section answers the question: “Was your goal met?" The students respond “yes," “no," or “partially". Students identify what they would recommend to the next shift based on whether or not their goals were met.

Clinical practice really is the ultimate active learning environment for nursing students. And with concept-based learning, all teaching is aimed at producing nurses who are skilled at thinking in the practice environment.

These three strategies are ways to work concepts into every clinical day. Concepts should extend into clinical practice to pull together all aspects of the nursing program's teaching methodology.

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