Introduction- Just as the theoretical and practical backgrounds of nursing have changed over the past several decades, so has the nursing education environment itself. . Students now entering the field are diverse in culture, educational background, and most especially age and experience. Traditional undergraduates coming directly from High School or Junior College often interact with more mature and experienced students. In addition, nursing instructors remain challenged to recognize different learning needs and styles, and respect that adaptive scenarios might be necessary to further the learning opportunities for many students. We thus see that the most effective way of teaching in the modern nursing classroom is to adjust one's pedagogical paradigm outward and to actively find new and innovative ways of reaching each student, rather than expecting each student to completely bend to the tried and true curriculum of previous generations (Young, L., Petson, B., eds., 2006). Too, we must not forget that foundationally the modern nurse leaders and instructor is expected to perform multiple roles and must therefore be prepared in a more humanities-based holistic curriculum themselves. This idea lends itself more to the area of moving beyond rote and into critical thinking areas. Critical thinking is primarily a way of looking at information, processing that information in an analytical manner, and being able to bring outside materials to bear upon the material studied. It is more of a process, and can be utilized in public speaking, reading, watching television or movies, or a general approach to daily life. In general, the basic aspect of critical thinking is to analyze the source material and decide upon its veracity and relevance learning (Ozturk, Muslu, & Dicle, 2007).
.Background - Mark G. is a second year nursing student who is one week away from his formative assessment. As the mentor in charge of this student, I have been collecting data about his performance through observation, written critiques from colleagues, reports from other faculty and staff, and Mark's own required documentation. Prior to completing any assessment, I find it helpful to both quantitatively and qualitatively review performance expectations, areas of concern or difficulty, basic skills, and action plans:
1 -- Poor or Unacceptable
3- Good, Needs Improvement
4 -- Very Good
5 -- Excellent
Basic Verbal Communica- tions
Unable to form cogent verbal sentences and explain issues
Able to explain basic concepts verbally
Adequate expression, fully under-standable
Very good communica-tion skills, able to follow and anticipate
Superior oral communica-tions, cogent, goes beyond ordinary abilities, highly professional.
2- Below average in verbal communication; has been counseled to seek help.
Basic Written Communica-tions
Unable to form cogent written sentences and paragraphs that explain issues
Able to explain basic concepts in written manner; many grammar or spelling errors
Adequate expression, fully under-standable, few mistakes
Very good communica-tion skills, able to follow and anticipate, littler or no mistakes
Superior written communica-tions, cogent, goes beyond ordinary abilities, highly professional.
2 -- Below average in written skills, has been counseled to seek help.
Inadequate or missing documentation, sloppy procedures
Barely meets standards for cogent docs.
Meets standards but still has errors or omissions
Meets all standards, few errors, good quality
Exceed expectations, very thorough, well documented, professional
2- Only gross or obvious items charted, "forgets" regularly
Wise use of time
Lots of down time, non-work chatter, cell phone use, not on task
On task most of the time, frequent breaks, inability to focus
Usually completes tasks on time but often needs reminding and supervision
Completes tasks professionally and on time, does not need to be "managed" for daily tasks.
Excels by anticipating further tasks without being told. Great self- managing skills
2- May show signs of ADD, unable to focus for longer periods of time.
Basic Nursing Care Skills
Inadequate attention to detail or tasks; inability to perform basic skills set
Has trouble remember-ing skill set and order; trouble charting
Adequate, rote memorization of skill set needs
Above average, good skills set, ability to work under pressure
Excellent skill set, top notch, anticipates patients' needs.
2 -- Basic skills set lacking; trouble remembering steps and protocol
Reflective Journal Entries
Poorly communicated, hardly any reflection, show no time or energy spent.
Bare Minimum reflection, inadequate use of disparate materials, shows little original thought.
Fulfills assignment, is reflective but very general and does not flush out concepts
Moves beyond rote, shows reflective skills that integrate clinical and advocacy paradigms
Superb skills, anticipates most very need, clearly feels the passion of health care and communicates as such.
2 -- Very little reflection shown, possibly because of inadequate writing skills, also possible David has never been asked to critical reflect.
Best Practice-Based Evidence Collection and Utilization (Analysis)
No evidence of understanding of BP modeling, unable to communicate such.
Little evidence of BP modeling, able to find some communications normality.
Good, rounded understanding of BP skills and implementa- tion
Good skills, but goes beyond BP to integrate skill sets.
Excellent BP skills that are consistent, well thought -- out, professional
2- Some evidence of understanding of BP but no cogent efforts shown to date.
(Weber and Kelly, 2003; Swansburg and Swansburg, 2002; ).
Overall Quantitative Score
Analysis- When assessing candidates, it is important to have very strict quantitative criteria by which to link performance goals. This eliminates the tendency to overly rely on personality and "feelings." Mark, in fact, is a very pleasant young man, with a winning smile, and an ease of personality that makes it easy for both patients and colleges to warm to. However, modern nursing is far more than just being able to provide for one aspect of patient care. The demands of the profession, the expectations of hospitals, care facilities, colleagues, and physicians are far higher than ever, and the requirements for the profession far more stringent than in the past. It appears we have 4 choices with Mark, all of which depend on his commitment and abilities to perform under pressure.
Place Mark on probation for 90 days, his degree progress on hold; specifically during that time Mark must make concerted efforts to move all scores in the 2 range to minimum of 3. This may involve tutoring, etc.
Move Mark back into a 1st year class to repeat course work (charting, etc.) which should help him develop the skills needed if there is a learning disability -- potential psychological and/or fiscal issues.
Drop Mark from the program or suggest he move into Medical Technology, Phlebotomy, or another Medical Aspect.
Allow Mark to continue without probation, only a verbal warning that he must improve prior to next evaluation (Bulman and Schutz, eds. 1997; Cramer & Davidhizar, 2008).
Conclusions - Based on the evidence at hand, as well as Mark's personality, financial commitment thus far, and the overall impression of working with him, I would tend to recommend option 1 above. This is not simply for Mark's benefit, although that is the primary goal, but for the benefit of the profession. ). According to the American Association of Colleges of Nursing, "the United States is in the midst of a nursing shortage that is expected to intensify as baby boomers age and the need for health care grows. Compounding the problem is the fact that nursing colleges and universities across the country are struggling to expand enrollment levels to meet the rising demand for nursing care" (Rosseter, 2011). Students are not cogs in a large factory wheel, but individuals who must be mentored and cherished into new roles. Educational institutions, like companies, need to focus not on individual products or services, but at solutions for individual student needs (Epp & Price, 2011). By giving Mark the confidence and tools with which to perform, but a strictly enforced timeline, he can choose to succeed if…