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Advancing Nursing Skills Mastery at the University of Rochester

Customer Story

The University of Rochester’s School of Nursing adopted a new approach to ensuring students' competence in fundamental skills. 

University of Rochester School of Nursing

About

The School of Nursing at the University of Rochester in Rochester, New York, currently serves nearly 170 students in its 12-month and hybrid-online 24-month accelerated bachelor's (ABSN) programs.

The challenge

Mastering foundational skills with asynchronous learning

Kaitlyn Picard, MS, RN, CCRN, CNE-cl is an Assistant Professor of Clinical Nursing and instructional design coordinator for the School of Nursing at the University of Rochester. In this role, she collaborates with course faculty to create learning activities and assessments that effectively build competence and ensure students are practice-ready.

Kaitlyn and the faculty recognized a need to incorporate more deliberate practice opportunities that allow students to master key foundational skills, like sterile field setup and inserting catheters.

"We were hearing over and over from our clinical faculty that students were not competent with specific skills [like IV medication administration] by the time they reached the last semester,"1 she explains. This finding is not specific to the University of Rochester's nursing program. It's well-documented in the nursing education literature that new graduate nurses are not fully prepared for practice.2

To fill the gap, they needed to find ways to build in more practice opportunities, including:

  • additional practice in and outside of the lab in their 12-Month Accelerated Bachelor's in Nursing program
  • independent, remote practice in their hybrid-online 24-Month Accelerated Bachelor's in Nursing program

 

Supporting Competency-Based Education

The emphasis on increased practice opportunities supports the program’s shift to competency-based education (CBE).

"One of the key pieces [in CBE] is to have repeated exposure. You really need to ensure that students have multiple opportunities to practice whichever competency they’re trying to build."

- Kaitlyn Picard, MS, RN, CCRN, CNE-cl
Assistant Professor of Clinical Nursing, University of Rochester School of Nursing in Rochester, New York

Kaitlin Picard

Kaitlyn and the faculty use the backward design framework to help their shift to CBE. This framework involves identifying an end goal – in this case, competency in specific high-impact skills – and then working backward to align activities and assessments to help students meet the goal.3

“We worked together using the backward design framework to really ensure all learning activities and assessments were aligned throughout the course, but also throughout the curriculum,”4 she explains.

The solution

Self-directed, peer-to-peer learning

SimCapture for Skills training at Rochester University School of Nursing

To address the need for more deliberate practice to help build competency, Kaitlyn and the faculty decided to try SimCapture for Skills paired with the Modular Skills Trainer.  SimCapture for Skills is a digital assessment and evaluation tool that supports student-driven learning. It works with the Modular Skills Trainer to:

  • Provide opportunities for deliberate, asynchronous practice of fundamental skills – from anywhere.
    "What’s nice with the Modular Skills Trainers is that they have the key pieces that you need to practice high-impact skills – and you can really do that in any environment," she says. Students can practice repeatedly until they’re confident.
  • Provide efficient, self or peer evaluation using objective, built-in checklists.
    "Because we have the skills checklists built into SimCapture, when students are ready to practice, they can pull up their skills checklist in SimCapture and they can choose to record themselves so that then they can perform a self-evaluation," she explains. "They can [also] do peer evaluation in real time. You can connect with a peer who could be in a completely different environment because of the virtual connection. And they can watch you in real time and complete the peer evaluation right in the checklist in SimCapture."
  • Track learners' progression with robust data reporting to verify competency.
    “There’s a ton of data you can capture in SimCapture,” she says. The data yields insights on progression at the individual and cohort level. And, it also provides visibility into how much time the students spend on skills practice.

 

The results

Effective, efficient skills mastery

Utilizing SimCapture for Skills with the Modular Skills Trainer helped Kaitlyn and the faculty in several areas.

modular-skills-trainer-student-practice.jpg

Embracing the benefits of self-reflection and peer feedback

Kaitlyn found that the self-evaluation and peer evaluation options in SimCapture for Skills were key to helping students grow.

"A crucial piece...is self and peer evaluation during those practice opportunities," she says. "There’s a ton of literature out there [indicating] that there’s a lot of power in self-reflection, but also peer evaluation in order to improve."

"Nursing is such a collaborative discipline. Engaging in self-reflection and providing peer feedback can only build those communication and interdisciplinary collaboration skills that are just so important in our discipline."

Benefitting from data-driven insights

SimCapture for Skills yielded student performance data that allowed Kaitlyn and the faculty to:

  • Organize the data in one place.
    Previously, they kept data in numerous places – making it difficult to compile.
  • Track students' progression across the curriculum.
    "That’s key in CBE," she says. "You need to see how much students are practicing and how their practice and skill levels change throughout those practice exposures."
  • Pinpoint areas where students were struggling.
    Because the data provided performance insights at the course and cohort levels, Kaitlyn and the faculty could quickly identify common issues. Then, they could look at the didactic data to determine if it needed adjusting.

Better transparency

Using checklists in SimCapture for Skills allowed Kaitlyn and the faculty to increase transparency for the students, helping them to know exactly what they needed to do.

"[Something] that has become really evident to us is that transparent assessment in an accelerated program is key," she notes. The rigorous full-time program can be challenging for students because of the nature of its pace. "One way we can [help them succeed] is to be really transparent in what we want and what we expect of them."

"Having transparent assessments is an evidence-based teaching strategy," she adds. "So SimCapture helps us with that. We can tell students, 'Here’s the checklist you’re practicing with. It’s the same checklist that we're going to evaluate you within your summative demonstration.'"

Increased uniformity

Using checklists increased the level of uniformity because all students were being objectively measured based on the same checklists. This also helped maintain objectivity with the faculty. The approach to student evaluations can vary based on a number of factors. The checklists include hint text to help provide an objective measurement for faculty to consider when completing student evaluations.

Greater efficiency in evaluation

The ability for students to perform self or peer evaluations helped free up some much-needed time for faculty. 

"When peer evaluation or even self-evaluation is done correctly, the students are really getting a baseline of how competent they are in performing the competency or skill," she explains. "When that process is occurring, they're constantly refining their skill performance. And then when they think that they're ready to demonstrate it, they can then go to the instructor." At that point, the instructor could provide more specific, refined feedback.

"That's really how it can lessen the workload of faculty – because students are leaning on each other to provide evaluation," she points out. "The instructor can spend more time checking in individually as they're practicing amongst each other, but then also are giving very detailed feedback when the student is ready to demonstrate – vs. giving them a ton of feedback because they haven’t practiced the skill."

3 keys to success

Kaitlyn's tips for success in finding success with SimCapture for Skills include:
Kaitlin Picard
  1. Recognize the importance of faculty development.
    "Faculty development is crucial. You need to talk to your faculty about what competency-based education is and how self-directed learning and peer evaluation play into competency-based education. I’m a firm believer that if the faculty don’t understand these theoretical underpinnings, they're not going to be able to support students with them."
  2. Help your students understand the "why."
    "We need to also educate our students on what competency-based education is and how self-directed learning and peer evaluation fit in. It’s important to explain the 'what,' but also the 'why' we are doing this."
  3. Enlist a champion to lead the program.
    As the instructional design coordinator for the ABSN program, Kaitlyn served as the champion for her program. "I worked very closely with the course faculty to get their input surrounding the respective courses they teach. From my lens, it was crucial to have someone as the lead who learned all about the SimCapture platform to support faculty with its implementation. In my experience, faculty are hesitant to implement anything if they are uncomfortable with it, so this was a way to partner with them, get their insight on what they think will work best/what should be prioritized, but also support them where needed."

References

  1. Psychomotor Framework for Students to Master High-Impact Skills. (2024, September 4). Nurse Educator Tips for Teaching Podcast. Retrieved from https://nurseeducatorpodcast.libsyn.com/psychomotor-framework-for-students-to-master-high-impact-skills
  2. Kavanagh, J., & Sharpnack, P. (2021). Crisis in Competency: A Defining Moment in Nursing Education. The Online Journal of Issues in Nursing, 26(1). https://doi.org/10.3912/ojin.vol26no01man02‌
  3. NLN Competency-Based Education Toolkit. (2024). National League for Nursing. Retrieved from https://www.nln.org/docs/default-source/default-document-library/nln_cbe_toolkit_2024.pdf?sfvrsn=2015cb55_3/%20NLN_CBE_Toolkit_2024.pdf
  4. Psychomotor Framework for Students to Master High-Impact Skills. (2024, September 4). See reference #1.