Presenting Advanced Cardiac Life Support (ACLS) to nurses using Emotional Intelligence

1. Presenting Advanced Cardiac Life Support (ACLS) to nurses using Emotional Intelligence Theodore A. Pettinicchi, MSN, RN-BC Walden University

2. Objectives • Participants will be able to describe emotional intelligence • Participants will be able to state the importance of learning in the affective domain • Participants will be able to list two ways to apply emotional intelligence to teaching

3. Introduction • In this presentation, we will be discussing incorporating Emotional Intelligence (EI) into teaching the American Heart Association’s Advanced Cardiac Life Support (ACLS) course to nurses who have never had the course before.

4. Introduction • What do you think emotional intelligence is? • Is it emotional learning? Learning about emotions? • Should you employ teaching methods which address learners’ emotions?

5. Introduction • Definition: what is emotional intelligence (EI)? • According to Daniel Goleman’s model of emotional intelligence, it consists of five major components: • Knowing one’s own emotions (self-awareness) • Managing these emotions (self-regulation) • Self-motivation (learning because I want to) • Recognizing emotions in others (social awareness) • Handling relationships (social skills)

6. Introduction • What does EI mean to the adult learner? • Address adult learning needs based on EI • self-awareness: understanding of one's strengths, weaknesses, emotions, needs and drives • self-regulation: impulse and behavior control • self motivation: achieve for intrinsic reasons • social awareness: empathy • social skills: proficiency in managing relationships; conflict management; rapport

7. Introduction • Experiences are “colored” or “flavored” with emotions • A strong emotion can be connected to an experience and evoke it again when a similar experience occurs Reeves (2005)

8. Introduction Reeves (2005) also points out that situational stress can undermine decision-making, concentration, and recall, which can lead to an increase in errors. The physiology behind this is that the emotion center of the brain, the amygdala, can override higher, cognitive thinking and interfere with performance. This is likely from where test anxiety arises.

9. Learning in the affective domain • We give much attention to learning in the cognitive domain: “Certain drugs can promote ion ‘set up’ in the myocardium” • And, to learning in the psychomotor domain: “I am correctly redemonstrating cardiac compressions” • We need to teach more to the affective domain: “I am excited that I know what to do for a patient during a resuscitation”

10. Learning in the affective domain • Adults learn on an “importance scale”: why do I need to learn this? Learning needs to be meaningful and have value • Affective learning adds meaning to the content learned • Adults construct their own meaning for their learning Merriam, Caffarella, & Baumgartner, (2007)

11. Learning in the affective domain • Adults process their learning and assign meaning to it in this way. • Emotions can influence and increase the meaning • More meaning = stronger, more effective learning

12. How does this apply to teaching ACLS to nurses? • We need to teach ACLS through addressing these adult EI learning needs: • self-awareness: address fearfulness in nurses by allowing them to be Code Leader in an emotionally safe environment • self-regulation: “a quiet code is a happy code”—no yelling or carrying on

13. How does this apply to teaching ACLS to nurses? (cont.) • We need to teach ACLS through addressing these adult EI learning needs: • self motivation: “I want to learn ACLS so I’m prepared” • social awareness: teach all nurses that New to Practice RNs can be really frightened and will need support in a code • social skills: teach the AHA’s Team Resuscitation concept: mutual respect, elicit contributions, positive reinforcement

14. More Effective ACLS education • By teaching to adult learners’ EI needs, ACLS education can become more effective • Concepts are better retained • Internalization of key points is enhanced • Outcome: through these techniques, nurses are more effective ACLS providers • Outcome: More effective nurse providers of ACLS promotes more successful patient outcomes.

15. Outcomes Nurses’ skills with EI lead to better interpersonal relationships, which are associated with positive patient outcomes through healthy work environments (Codier, Molina Kooker, & Shoultz, 2008) According to Codier, Molina Kooker, & Shoultz (2008), nurses can be taught EI which be improved toward developing an environment of respect through better communication.

16. How, then, is EI incorporated into an ACLS course? • This can be accomplished by: • Promoting a collegial atmosphere in the classroom portion through eliciting questions and encouraging discussion • Presenting the practical, scenario-based, decision-making portion of the course (the MegaCode) as a group effort, with all members contributing toward the common goal of treating a patient’s cardiac arrest • Making that MegaCode experience nonthreatening and keeping it an emotionally safe environment, focused on the learning

17. Examples of how to incorporate EI: • Promoting a collegial atmosphere in the classroom: • While ACLS depends heavily on audiovisuals, the instructor is present to answer questions. • Questions must be answered in a supportive, respectful manner. • Encourage discussion of the content presented by asking whether the learners have had any experiences using ACLS prior to this class and ask them to briefly describe these (as time permits)

18. Examples of how to incorporate EI: • Presenting the MegaCode as a group effort • Upon taking a group of learners into the simulation room with the manikin and other training equipment, ask where the learners work (one is from the ER, one from ICU, etc) to construct a scenario most like the learners’ experiences thus far • Each will take a turn as Code Leader (primary decision maker). If they “freeze”, skip their turn and come back • During the development of the resuscitation scenario, allow the “helpers” (non-Code Leaders) to contribute suggestions to assist the leader

19. Examples of how to incorporate EI: • Making that MegaCode experience nonthreatening and emotionally • Ensure there is mutual respect among the learners during the scenario • Elicit assistance from the group for the Code Leader when they do not know the answer or are unsure • Whenever possible, within course guidelines, ask leading questions of the learners so that they may arrive at the answer they need on their own, should they come up blank • Working together as a team in the resuscitation scenario fosters the social skill of managing professional relationships

20. Conclusion • Emotions affect what and how adults learn • Emotions can reinforce or hinder learning • Adults should be taught with emotional intelligence in mind, as addressing its areas of influence will enhance adults’ learning • Examples of how emotional intelligence can enhance nurses’ learning of ACLS include promoting collegiality, presenting the MegaCode as a group effort and keeping it an emotionally safe environment, focused on the learning

21. Evaluations • Please email your evaluations to me at either: • Theodore.pettinicchi@waldenu.edu or • pettinit@UPHS.upenn.edu

22. References Cherniss, C., Extein, M., Goleman, D. & Weissberg, R. P. (2006) Emotional Intelligence: what does the research really indicate? Educational Psychologist, 41(4), 239–245 Codier, E., Molina Kooker, B., & Shoultz, J. (2008) Measuring the Emotional Intelligence of Clinical Staff Nurses: an approach for improving the clinical care environment. Nurs Admin Q, 32 (1), 8–14

23. References Latif, D. (2004) Using emotional intelligence in the planning and implementation of a management skills course. Pharmacy Education, 4 (2), 81-89. Merriam, S. B., Caffarella, R. S., & Baumgartner, L. M. (2007) Learning in adulthood: A comprehensive guide. San Francisco: Jossey-Bass. 380-383.

24. References Reeves, A. (2005) Emotional Intelligence: recognizing and regulating emotions. AAOHN Journal, 53 (4) 172-176