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A Brave New World: How technology in the classroom is changing nursing education

Posted: Oct. 2, 2012

When Corinne Grimes, PHD, RN, began teaching nursing students 30 years ago, no one knew what an iPad or iClicker were, much less how to use them. Students were expected to take notes with paper and pen because laptop computers hadn’t been invented, and Twitter was still just a gleam in a young boy’s eye.

“Back then, instructors could only hope that they were getting through and that students were absorbing and learning — not to mention staying awake,” said Grimes, director of the Learning Center at the School of Nursing. “Unfortunately, we wouldn’t find out how well they were doing until exam time, which was often too late.”

Today, professors at The University of Texas at Austin School of Nursing can get real-time feedback thanks to radio frequency response systems, such as the iClicker. These handy electronic gadgets are used for grading and keeping track of attendance and, most importantly, measuring student involvement. That information, according to Grimes, can help instructors to identify marginal students who otherwise might fall through the cracks.

Simulation Lab instructors

Simulation Lab instructors Shannon Patton (left) and Scott Hudson
monitor student interaction with high-fidelity mannequins.

Even before the iClicker arrived on the scene, other classroom performance systems (CPS) used by the School of Nursing verified what she and others had thought was the case: students tend to “zone out” during traditional teacher-led, fixed-content instruction methods, such as lectures or PowerPoint presenta­tions. Conversely, when more interactive methods are part of the instruction time, students feel engaged. For example, more than half of the students in a recent survey said they felt more involved in class. In addition, their test scores rose by approximately 8 percentage points compared to a previous group of students taking the same course.

Like it or not, technology in the classroom is here to stay. And many, if not most, teachers, students and administrators are finding that they like it — a lot.

The goal of universities everywhere is to improve both student learning and academic success, and many top-tier universities see technological advances as one way to accomplish this. In a recent blog post, Bill Powers, president of The University of Texas at Austin, expressed satisfaction with the institution’s growing use of technology in the classroom, noting that over the past year attendance in those classes implementing interactive classroom technology rose to 92 percent.

“It appears that students are learning more. As for faculty, they show little nostalgia for their old lecture formats and report being energized by greater interac­tion with students,” he said. “Indeed, far from making professors less important, the consensus is that these student-centered formats make professors more cru­cial than when they simply paced the stage.”

Shannon Patton, MSN, RN

Shannon Patton, MSN, RN, clinical faculty member,
creates realistic wound scenarios for student learning.

For nursing schools, the goal to improve learning and academic success is compounded by a need to prepare students to enter a field in which analysis, prediction and decision-making skills are critical. Not only must they develop innovative nursing programs and curriculum but also ensure that students receive necessary clinical experience. But sometimes obtaining bedside access to hospital patients can be difficult.

Referring to a School of Nursing study on the use of simulated clinical experience, Grimes explained that an increase in nursing programs in the Austin area means that more students are competing for the few existing spaces in acute care settings.

“There is pressure to move students more rapidly through certain specialized areas in acute care institutions, which shortens the student’s time at the bedside within these areas,” she said.

As a result, bedside care in hospitals alone may not be adequate to produce nurses who are able to assess and analyze emerging situations, formulate correct conclusions and rescue severely ill patients. To over­come that barrier, faculty and administrators have begun to look to technology, and in 2008 the School of Nursing built a simulation laboratory to repro­duce conditions and symptoms that students might encounter, particularly in high-risk areas. Fitted with high-fidelity mannequins that mimic real-life physical and emotional responses to illness states in a realistic hospital setting, students may now encounter every type of patient that a modern health-care facility has to offer, and then some.

The mannequins can be programmed to simulate thousands of physiological responses so that students are thrust into a variety of crises — from severe allergic reactions to cardiac arrest to seizures — that they must learn to correctly identify and respond to. While the students are busy assessing and caring for their “patients,” School of Nursing clinical faculty members and alumni Shannon Patton, MSN, RN, and Scott Hudson, MSN, RN, sit in a control room behind a one-way mirror programming the mannequins and monitoring the students’ actions.


Nursing student responding with iClicker.

“It can be a very stressful situation for some students,” said Scott Hudson, assistant director of the Learning Center and Simulation Center. “But then, nursing can be a stressful occupation.” One of the objectives of a simulated clini­cal experience is to allow students an opportunity to practice performing well regardless of the stressful nature of the clinical environment, he added.

For example, in the birthing center, students encounter Noelle, a mannequin that gives birth, smoothly transitioning between physiologic states, sometimes several times a day. Her baby may be in a breech position or she may require a C-section. Afterwards, both she and her newborn Hal need to have their vitals taken. Hal may develop trouble breathing or be in extremis with excessive crying and convulsions. You just never know. Which is the point, because most of the students have never encountered a woman in labor or held a baby, much less a newborn. The sessions last approximately 45 minutes, and in a debriefing afterwards the students have a chance to talk about what just happened and to justify their actions. Hudson explained that it’s during these debriefing sessions that the real learning happens.

“It was a great chance for me to practice nursing care in a critical, but safe, situation,” agreed one student. “The communication with the other students during the lab time and with the instructors afterwards was invaluable.”

Corinne Grimes

Corinne Grimes, Director of the Learning Center

Simulation in the form of case studies and role-playing arose centuries ago, and simulators developed during World War II proved especially valuable when the need to rapidly train fighter pilots was critical, said Grimes. Today’s human simulators, however, are light years beyond anything produced in the mid-twentieth century. These sim lab mannequins, costing upwards of $60,000 each, are exquisite examples of high-tech engineering that require a similar level of expertise to operate in order to achieve the desired learning outcomes. But Grimes said it’s worth the expense and effort because evidence shows that students who spend time in simulation labs may more easily spot physiologic changes and more rapidly and safely respond on a team or individual level. In other words, the hope is that failure to rescue a patient showing signs of deterioration will become more rare in the clinical setting as a result of practice within the safe environment of the simulation laboratory.

“Our School of Nursing prides itself on rigorous curricula at both the undergraduate and graduate levels with innovative classroom, clinical and community experiences,” said Alexa Stuifbergen, dean of the School of Nursing. “We have thoroughly embraced today’s valuable technological tools to prepare students for a career in nursing and are also keeping our eye on tomorrow’s advances.”

So, what’s in store for nursing education? According to the National League for Nursing, a rapid growth in information technology will continue to make a radical impact on health-care delivery and the education of nurses. Advances in processing capacity and speed, the development of interactive user interfaces, and the increased affordability of personal computers will continue to contribute to the explosion of information technology applications. Faster and more flexible access to data and new means of observation and communication will also have an impact on how nursing research is conducted. Without doubt, nurses of the 21st century will increas­ingly encounter the use of technology to stimulate critical thinking and skill acquisition.

Sounds like Noelle, Hal and their cohorts have a busy future ahead of them providing students at the School of Nursing with hours and hours of unpredictable scenarios.

A brave new world indeed.