by Anne Z. Cockerham, PhD, CNM, WHNP-BC, CNE
Associate Dean of Academic Affairs and Professor of History
Building on FNU’s long-standing commitments to teaching excellence and innovation, we launched the Center for Innovative Teaching and Learning (CITL) in early 2017. CITL is a collaborative effort between Associate Dean of Academic Affairs, Anne Cockerham; Innovation Coach, Tia Andrighetti; our two instructional designers, Laura Orsetti and Ally Williams; and many faculty, staff, and administrators across the university.
The Center’s two major goals are to: (1) vigorously promote innovation as an iterative process of exploration, evaluation, and sharing, to improve student learning outcomes; and (2) safeguard student-centered, evidence-based teaching and learning as a vital task of the university.
The first major project for CITL is the development, implementation, and evaluation of a curriculum-wide program of simulations delivered at a distance. We chose this as the first CITL project because FNU faculty members are constantly seeking ways to enhance our students’ application of clinical knowledge, critical thinking, and diagnostic reasoning skills. We decided to begin incorporating distance-delivered simulations in online didactic courses in order for students to be able to engage in the content through the applications of concepts. An important goal is that the preceptors and clinical sites who host our students will benefit from students whose didactic courses prior to their clinical practica included extensive application of knowledge and skills to realistic patient situations. Ultimately, the clients served by our students and graduates will benefit from the intense preparation for clinical practice that our students will receive through simulation.
Our distance-delivered simulations will be aligned with the objectives and needs of each course and we’re using a variety of technologies and approaches. A few examples include: web conferencing software, standardized patients, student peer-interaction activities, branching case scenario software, guided reflection, student self-evaluation, varying assessment types, and debriefing.
Here are a few examples of distance-delivered simulations:
- A breastfeeding phone triage simulation. A standardized patient plays the role of a new mother and speaks with each student by phone. The experience simulates after-hours patient phone calls. Following the simulation, the standardized patient provides feedback to each student about how they made her feel as a patient and then the student writes and submits a clinical SOAP note (subjective, objective, assessment, plan).
- A health history, standardized patient/provider encounter. Students meet with a standardized patient in BigBlueButton (web conferencing software integrated in the learning management system/Canvas) for a face-to-face, one-on-one interview to elicit a basic health history. Session is recorded. SP provides feedback after interview then students submit a reflection and SOAP note
- An interactive, branching case study using Twine. Students work through patient histories by reading a case study and answering questions about what information to solicit from the patient. Then they perform a physical exam listening to recorded segments of heart and lung sounds and decide what other data is needed. Students then form an assessment and plan based on their findings. Students assess their knowledge using a pre and post test and more information is available if they need more practice with the didactic content.
CITL is facilitating extensive support, coaching, and feedback loops to promote this initiative. Cohorts of four course coordinators per term will design and implement distance-delivered simulations in their courses by working through a formal training and simulation-development course: Innovation 101: From Imagination to Simulation. Additional faculty development support includes: in-depth debriefing training, a Simulation Resource Center, course faculty-specific simulation training, and ongoing support from the CITL staff. Members of a special subcommittee of the Curriculum Committee, Simulations Across the Curriculum, perform valuable service to the simulation initiative by serving as a simulation advisory group, providing ongoing support of quality assurance for simulations, addressing faculty development needs related to simulation, and offering a faculty Simulation Journal Club. Faculty that work closely with students in clinical practicum are providing feedback about clinical students’ knowledge and skills that could benefit from enhanced focus and application via distance-delivered simulations during earlier didactic courses. We are exploring ways for clinical preceptors to provide feedback to inform the simulation program.
According to CITL director and Associate Dean of Academic Affairs, Anne Cockerham, “Students are at the center of our teaching and learning activities and we keep that as a guiding principle of our simulation initiative, beginning with the planning stages of a simulation and continuing until after the simulation is over. We’re ensuring that students are well-prepared for their simulation experience, from technology- and content standpoints. We have an extensive evaluation process to gather feedback from students about their experiences, including how well the simulations contributed to their learning, whether they experienced any technological or logistical problems, and how the simulations affected their self-confidence in the content and skills associated with the simulations.”
We are excited about this new initiative and, especially, about partnering with students to deepen their understanding of course content and skills. If you have ideas or feedback, please contact Anne Cockerham at firstname.lastname@example.org.