Teaching IL Skills During Nursing Student Clinical Experiences

1. Teaching IL Skills During Nursing Student Clinical ExperiencesWILU 2007 Rian Misfeldt, Instruction and Information Literacy Librarian and Program Head, Library and Testing Centre SIAST Wascana Campus Regina, Saskatchewan

2. Let’s start with a question! • Why are we here? • Typically, no “department of information literacy” in our university faculties; or “library skills” program in our tech. colleges. Rian Misfeldt - WILU 2007

3. Possible Answer • Information literacy skills are constructive or even transformative; allow us to “pick the ingredients” that become the recipe for who we are: • as family members • as citizens • and as professionals Rian Misfeldt - WILU 2007

4. Today’s Session • Background about SIAST; our environment • IL in this environment • Motivations for this project • Outline of “clinical experience” course Rian Misfeldt - WILU 2007

5. Today’s Session…con’t • Description of the overall project from planning to post-conference debrief • Preliminary results • Where the project stands now • Conclusions • Where did this come from? Rian Misfeldt - WILU 2007

6. Sask. Institute of Applied Scienceand Technology • Medium-sized technical college with campuses throughout the province: • Moose Jaw (Palliser Campus) • Regina (Wascana Campus*) • Saskatoon (Kelsey Campus) • Prince Albert (Woodland Campus) (*Project occurred only at Wascana Campus) Rian Misfeldt - WILU 2007

7. Sask. Institute of Applied Scienceand Technology…con’t • ~12,000 student with thousands of other individual registrations • Proven to have a major economic impact in the province • Focus is on careers and workplace skills; from the website: Rian Misfeldt - WILU 2007

8. Sask. Institute of Applied Scienceand Technology…con’t “Through partnerships with business and industry, we ensure our curriculum matches opportunities and needs in the workplace - an approach that results in high employer satisfaction with SIAST graduates.  Our consultative approach and commitment to real-life learning contribute to a graduate employment rate consistently in excess of 90 per cent.” Rian Misfeldt - WILU 2007

9. NEPS • The Nursing Education Program of Saskatchewan (NEPS) is a partnership among SIAST, the University of Saskatchewan and the First Nations University of Canada. • ~140 students completing all 4 years of their degree at Wascana Campus in Regina Rian Misfeldt - WILU 2007

10. History of IL at SIAST Libraries • Similar to most post-secondary libraries • Good participation among SIAST Programs • Sold largely as Internet/Technology skills at first • Moving toward integration into course frameworks Rian Misfeldt - WILU 2007

11. History…con’t • NEPS is no exception; library sessions built on “orientation” – then, later, writing assignments (i.e. need for better research) • Framework (i.e. curriculum) integration being ramped up this coming year in Year 1 and also in Year 2 Rian Misfeldt - WILU 2007

12. BUT… • At SIAST we want our graduates to be assets to their employers • Is teaching nursing students how to identify, access, and apply research in their major papers/assignments enough? • Will they make the connection and apply the same IL skills in the workplace? Rian Misfeldt - WILU 2007

13. Competency Standards • Sask. Registered Nurses Assoc. (SRNA) implemented new Standards, March 2007 • I identified five Competency Standards as related to IL plus this initial statement: Rian Misfeldt - WILU 2007

14. Competency Standards…con’t “Four major domains are identified within the profession of registered nursing: direct care provider, educator, administrator, and researcher.” Rian Misfeldt - WILU 2007

15. Competency Standards…con’t #12. Promotes current evidence-informed best practices. #30. Proactively seeks new information and knowledge and utilizes best practice in the provision of nursing care. Rian Misfeldt - WILU 2007

16. Competency Standards…con’t #50. Provides nursing care that is informed by evidence relevant to primary health care, health and healing. #51. Incorporates evidence from research and clinical practice, in conjunction with client preference, to make decisions about client care. Rian Misfeldt - WILU 2007

17. Competency Standards…con’t #59. Assists clients to identify and access health and other relevant resources in their communities. Rian Misfeldt - WILU 2007

18. Clinical Experience • A point for connection; communicating that “this is what nurses do!” • During a conversation with a NEPS instructor, Ann-Marie Urban, focus shifted from classroom to the clinical rounds courses Rian Misfeldt - WILU 2007

19. Clinical Experience…con’t • “participant will integrate Year 1 skills and practice skills in data collection (including diagnostic tests), assessment, planning, implementing and evaluating client care” Rian Misfeldt - WILU 2007

20. Clinical Experience…con’t • “…each participant will have the opportunity to provide holistic nursing care for clients in one of the following settings: medical, surgical, mental health, etc….” • A “practice” in every sense of the word Rian Misfeldt - WILU 2007

21. An Information Problem • Each week in a 6-week clinical round, students are assigned a client • Their goal is to “become informed” about the client and develop a concept map (i.e. care plan) • Concept maps are not “research” assignments; rather, an exercise nurses do in practice Rian Misfeldt - WILU 2007

22. An Information Problem…con’t • The instructor admitted that many aspects of previously completed concept maps contained facts and statements from unknown sources. • Other discussions revealed students were using texts, Google, handbooks, and notes to develop concept maps Rian Misfeldt - WILU 2007

23. The Session • Instructor agreed that a Librarian should be involved • 90-minute session with follow-up by means of a post-conference debrief. Rian Misfeldt - WILU 2007

24. The Session…con’t • Outcome: “Students will develop an understanding that they must create and hone an internal filter in order to discern the best information sources that will contribute to a meaningful and safe plan of care.” Rian Misfeldt - WILU 2007

25. The Session…con’t • Focuses on need for quality, credible information in clinical settings • Article analysis, Washington Post article, “Point. Click. Think?” [July16, 2002] • Students give me three points that “struck” them as interesting (many point out the John Hopkins University case) Rian Misfeldt - WILU 2007

26. The Session…con’t • Stephen Colbert video clip on Wikipedia • Students must reflect on what the comedian was really saying • I then ask 3 BIG questions about information • Where does information come from? • Where do we get information? • What is “good” information? Rian Misfeldt - WILU 2007

27. The Session…con’t • Scenario Searches • Related to the round they are entering (surgical, mental health, medicine) • They are instructed to “become informed” about the client in the scenario Rian Misfeldt - WILU 2007

28. The Session…con’t • Bibliographic Instruction section • Resources explored depends again on which round • e-CPS, Compendium of Pharmaceutical Specialties • CINAHL, books, ebooks, journals Rian Misfeldt - WILU 2007

29. The Session…con’t • Web Resources related to clinical round topic • One of the few “prescriptive sections”; website evaluation reviewed though • Some “advanced” Google functions explored • Scenario search attempted again Rian Misfeldt - WILU 2007

30. You are the Filter! • “It’s the thought that counts!” • You may only use a handbook or a textbook for your information • Or you may go beyond these sources and try information from a Library resource or website (i.e. use Google) • …as long as it’s the product of a thought process. • Health care providers must face the challenge of using good research, evidence, or information in their practice. Rian Misfeldt - WILU 2007

31. Post-Conference Debrief • traveled to the hospital to meet the student after ~4 weeks • Debriefs are times of discussion, sharing experiences, reflection • Instructors allowed me to have this time to see how students were handling the “information problem” of becoming informed about their clients Rian Misfeldt - WILU 2007

32. Post-Conference Debrief…con’t • Small survey to begin: [see handout] • Not scientific – gave us an indication though Rian Misfeldt - WILU 2007

33. Post-Conference Debrief…con’t • General discussion ensues • ~40 minutes or less • Positively received (tired but stayed with me!) Rian Misfeldt - WILU 2007

34. Preliminary Results/Reactions • Quality of concept maps – somewhat higher (no bibliography but still apparent) • Patient education and comfort level with patient education increased • Interaction with clinical practitioners and instructors during the clinical round was up Rian Misfeldt - WILU 2007

35. Results/Reactions…con’t • Many instances of students using resources I showed them and relating information found to clients, practitioners, and instructors • I’m an educator; introduced and treated as a fellow instructor Rian Misfeldt - WILU 2007

36. Where are we now? • To date, I’ve completed 4 such sessions and debriefs for 48 students • Meeting next week to discuss all Year 2 students participating in this learning (over 140!) • My librarian colleagues at Wascana and Kelsey will be delivering these sessions Rian Misfeldt - WILU 2007

37. Research possibilities • Due to the expansion we’re planning on placing a research framework on the practice • Qualitative/Quantitative (pre- and post- test with survey) • Suggestions??? • To see if connection of IL skills to clinical setting was made… • Article submitted to both Nursing and Library journals Rian Misfeldt - WILU 2007

38. Conclusions • Where this did NOT originate: • Not a push from our SIAST Libraries Academic Director (certainly supported though!) • Not a push from the Nursing Division Dean • Not even from reading an IL article in library literature or attending a conference lecture such as this… Rian Misfeldt - WILU 2007

39. Conclusions…con’t • Was a result of: • Close relationships with faculty, with librarians as co-educators • The commitment to students leaving SIAST with ALL the skills their profession demands • Going where we’re needed • The drive to seed the Information Literacy culture among health care providers that’s so desperately needed for evidence-based practice. Rian Misfeldt - WILU 2007

40. Thanks! Barnard, A., Nash, R., & O’Brien, M. (2005). Information literacy: developing lifelong skills through nursing education. Journal of Nursing Education, 44(11), 505-10. Faculty Matters. Nursing Education Perspectives, 26(5), 266-7. Kirk, J. (2004). Information and Work: Extending the Roles of Information Professionals. Challenging Ideas, ALIA 2004 Biennial Conference, September 21-4, Gold Coast, Queensland, URL (consulted May 2007): http://conferences.alia.org.au/alia2004/pdfs/kirk.j.paper.pdf Lloyd, A. (2005). Information literacy: Different contexts, different concepts, different truths? Journal of Librarianship and Information Science, 37, 82-88. Rian Misfeldt - WILU 2007

41. Thanks! Pravikoff, D.S., Pierce, S.T., & Tanner, A.B. (2005). Readiness of U.S. nurses for evidence-based practice. American Journal of Nursing, 105(9), 40-52. Saskatchewan Registered Nurses Association. (2007). Standards and Foundation Competencies for the Practice of Registered Nurses. Regina: SRNA. Sessions-Stepp, L. (2002, July 16). Point. Click. Think? As Students Rely on the Internet for Research, Teachers Try to Warn of the Web’s Snares. The Washington Post, p. C01. Skiba, D.J. (2005). Preparing for evidence-based practice: revisiting information literacy. Nursing Education Perspectives, 26(5), 310-1. Rian Misfeldt - WILU 2007