Student-Centered Learner Outcomes
A nurse educator must understand the relationship between program outcomes, course outcomes and student centered unit learner outcomes so that they are aligned and able to be used as methods for evaluation (Billings & Halstead, 2012). Program, course, and student-centered learner outcomes can be thought of as hierarchical so that the lofty goals of the program can be broken down into measurable means to propel the student to a high level of achievement. Program outcomes are the 10,000 foot view and overarching goals of the program and need to be aligned with regulatory agency requirements, mission and vision of both the college and of the school of nursing to define what qualities and characteristics of a nurse the college seeks to generate (Billings & Halstead, 2012). A subset of the program outcomes are level outcomes and generally outline what the student should value, know or be able to do in the freshmen, sophomore, junior and senior levels of the program as experience increases levels of difficulty are challenged and clinical reasoning is fostered. Within the program and levels of nursing education, the individual courses specify outcomes to be reached by the end of the course that are congruent with program outcomes. Course outcomes describe what the student should know, value, or be able to do at the end of the course after having completed all of the concepts in the topical outline (Billings & Halstead, 2012. Robb, M., 2012).
To break it down further, within each course there are classes and lessons or hours of study that support the course concepts and objectives in the form of student-centered unit learner outcomes. Student-centered unit learner outcomes take the place of traditional teacher centered outcomes previously known as objectives, and provide well-defined purposes for education to take place and should state what the student will know, value, or be able to do in a particular unit of study (Billings & Halstead, 2012. Robb, M., 2012). They help the teacher to plan for learning activities and evaluate how well the students were able to grasp the concepts through teaching strategies (Billings & Halstead, 2012). Student-centered unit learner outcomes can also be used by the students to establish and prioritize what they need to learn to be successful. According to Killam (2013) a developer of learner outcomes can follow the acronym SMART to plan specific, measurable, achievable, realistic and time-specific outcomes.
For example, a broad topic for nursing students is medical-surgical (med/surg) nursing. Different aspects of medical surgical nursing are taught at varying levels of a four year BSN program. When planning for junior level med-surg courses, certain topics must be covered including adult, pediatric and childbearing med-surg nursing or in other words nursing across the life span.
Here is an example of course/clinical outcomes that could be used in a junior level Adult Health Med/Surg. course:
Learner will be able to:
Clinical reasoning involves applying theory to practice in complex and ambiguous patient centered scenarios for sound clinical judgement (Koharchik, L., Caputi, L., Robb, M., & Culleiton, A. 2015). All levels of learning including; remembering, understanding, applying, analyzing, evaluating and creating contribute to the development of clinical reasoning. A nurse must have a sound knowledge base and understand concepts before applying them to practice. Reflection on practice allows the nurse to analyze concepts employed and evaluate outcomes of care much like the nursing process that is cyclical. The higher levels of learning including analyzing, evaluating and creating found in the learner objectives best reflect the development of clinical reasoning and clinical judgment. Experience promotes mastery and creativity with clinical reasoning. As a nurse becomes a life-long learner and as career trajectory changes and specializes, all levels of learning are necessary.
References
Billings, D., & Halstead, J. (2012) Teaching in nursing: A guide for faculty (4th ed.). St Louis, MO: Elsevier Saunders.
Killam, L. (2013). How SMART are your goals? How to recognize and write SMART goals for change. Retrieved 8/14/15 from:
Koharchik, L., Caputi, L., Robb, M., & Culleiton, A. L. (2015). Fostering Clinical Reasoning in Nursing Students. American Journal Of Nursing, 115(1), 58-61. doi:10.1097/01.NAJ.0000459638.68657.9b
Robb, Meigan, M.S., R.N. (2012). The learner-centered syllabus. The Journal of Continuing Education in Nursing, 43(11), 489-90. doi:http://dx.doi.org/10.3928/00220124-20121024-26
University of Colorado Denver. (2007). Assessment and instructional alignment. Retrieved August 14, 2015 from http://www.ucdenver.edu/faculty_staff/faculty/center-for-faculty-development/Documents/Tutorials/Assessment/index.htm
To break it down further, within each course there are classes and lessons or hours of study that support the course concepts and objectives in the form of student-centered unit learner outcomes. Student-centered unit learner outcomes take the place of traditional teacher centered outcomes previously known as objectives, and provide well-defined purposes for education to take place and should state what the student will know, value, or be able to do in a particular unit of study (Billings & Halstead, 2012. Robb, M., 2012). They help the teacher to plan for learning activities and evaluate how well the students were able to grasp the concepts through teaching strategies (Billings & Halstead, 2012). Student-centered unit learner outcomes can also be used by the students to establish and prioritize what they need to learn to be successful. According to Killam (2013) a developer of learner outcomes can follow the acronym SMART to plan specific, measurable, achievable, realistic and time-specific outcomes.
For example, a broad topic for nursing students is medical-surgical (med/surg) nursing. Different aspects of medical surgical nursing are taught at varying levels of a four year BSN program. When planning for junior level med-surg courses, certain topics must be covered including adult, pediatric and childbearing med-surg nursing or in other words nursing across the life span.
Here is an example of course/clinical outcomes that could be used in a junior level Adult Health Med/Surg. course:
Learner will be able to:
- Understand accountability in healthcare and appreciate quality and safety integration for healthcare excellence. (Cognitive, Affective)
- Begin to use, analyze, interpret, and demonstrate the value of subjective and objective data and appreciate inter-professional collaboration to foster holistic care for patients. (Cognitive, Affective Psychomotor)
- Demonstrate the use of principles of evidence-based practice and foster life-long learning and a spirit of inquiry in themselves and others charged to them as patient educators. (Psychomotor Affective)
- Observe and develop professional and ethical behaviors as they holistically manage patients in their care. (Cognitive Affective)
- Evaluate and articulate the principles of pathophysiology and compare and contrast each patient’s definition of health with normal and abnormal assessments in patient-centered care. (Cognitive, Psychomotor)
- Identify and integrate technology and application of informatics can assist with data collection and analysis and care of patients in the clinical setting. (Cognitive, Psychomotor).
- Recall and define of the principles of standard and transmission-based precautions and name the appropriate personal protective equipment to employ for each type. (Remembering) Congruent with 1 and 4 of the course outcomes.
- Explain Multi-Drug Resistant Organisms associated with use and abuse of antimicrobials and summarize the importance of this concept in the clinical setting. (Understanding) Congruent with 1, 2, 4, and 5 of the course outcomes.
- Using the CDC Appendix A as a guide (can be accessed on the CDC website at: http://www.cdc.gov/hicpac/pdf/isolation/Isolation2007.pdf Demonstrate the ability to solve case scenarios for placement of patients with various infectious diseases on a hospital unit. (Applying) Congruent with 1, 2, 3, 4, and 6 of the course outcomes.
- Outline opportunities to break the chain of infection and identify specific situations where each stage in the chain is relevant in healthcare associated infections. (Analyzing) Congruent with 1, 2, 3, 4, 5, and 6 of the course outcomes.
- Evaluate the rate of hand hygiene compliance on a clinical unit based on the World Health Organizations Five Moments for Hand Hygiene criteria tool. (Evaluating) Congruent with 1, 2, 3, 4, and 6 of the course outcomes.
- Design a patient education pamphlet using credible resources on an MDRO of your choosing. (Create) Congruent with 1, 2, 3, 4, and 6 of the course outcomes.
Clinical reasoning involves applying theory to practice in complex and ambiguous patient centered scenarios for sound clinical judgement (Koharchik, L., Caputi, L., Robb, M., & Culleiton, A. 2015). All levels of learning including; remembering, understanding, applying, analyzing, evaluating and creating contribute to the development of clinical reasoning. A nurse must have a sound knowledge base and understand concepts before applying them to practice. Reflection on practice allows the nurse to analyze concepts employed and evaluate outcomes of care much like the nursing process that is cyclical. The higher levels of learning including analyzing, evaluating and creating found in the learner objectives best reflect the development of clinical reasoning and clinical judgment. Experience promotes mastery and creativity with clinical reasoning. As a nurse becomes a life-long learner and as career trajectory changes and specializes, all levels of learning are necessary.
References
Billings, D., & Halstead, J. (2012) Teaching in nursing: A guide for faculty (4th ed.). St Louis, MO: Elsevier Saunders.
Killam, L. (2013). How SMART are your goals? How to recognize and write SMART goals for change. Retrieved 8/14/15 from:
Koharchik, L., Caputi, L., Robb, M., & Culleiton, A. L. (2015). Fostering Clinical Reasoning in Nursing Students. American Journal Of Nursing, 115(1), 58-61. doi:10.1097/01.NAJ.0000459638.68657.9b
Robb, Meigan, M.S., R.N. (2012). The learner-centered syllabus. The Journal of Continuing Education in Nursing, 43(11), 489-90. doi:http://dx.doi.org/10.3928/00220124-20121024-26
University of Colorado Denver. (2007). Assessment and instructional alignment. Retrieved August 14, 2015 from http://www.ucdenver.edu/faculty_staff/faculty/center-for-faculty-development/Documents/Tutorials/Assessment/index.htm