Adapting to Change…Anticipating the Future
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6/29/2016
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Science of Competency-Based
(Nursing) Education
Claudia Johnston, PhD
Associate Vice President for Special Projects
Texas A&M University-Corpus Christi
Query Today?
• Can (should?)nursing curricula
be delivered effectively in other
configurations than utilized
now in the classroom-patient
room dyad?
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Why? – Health Care Delivery System
• Looming Physician Shortage
• 200,000 – 2020
• 80 hour work week = ↓ skill acquisition
• Nursing Shortage – Staff & Faculty
• 14.1% Faculty Shortage
• Growing Numbers of Students Denied Admission
• 1,000,000 Positions – 2012
• IOM Report - 98,000 Error Related Deaths
• Care Delivery Pattern Changes
• Increased Intensity of Care Needs
• Fewer Opportunities for Clinical Practice
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Standard Solution
• Increase Enrollment
• Waiting lists!
• Insufficent Faculty
• Insufficient Clinical Sites
• Plan 2? Plan 3?
• Whatever!
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Higher Education - 2005
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1/3 Other than White
43% Older than 24
80% Employed
39% Employed Full-Time
10% Have a Disability
1998 – Average Age Game Player – 18
2004 – Average Age Game Player – 29
NCES 2003
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Why?
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> 1982 – 88 M
‘Cool to be Smart’
89.5% Computers
63% Net Savvy
14.3% 3-4 Yrs Use the
Net!
US Census
Pew Study 2005
Tapscott, 2005
Prensky, 2003
The NetGen
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10,000 Video Games
250,000 e-Mails
500,000 Commercials
20,000 Hours – TV
10,000 Hours – Cell
Phone
• <5,000 Hours Reading
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MoreWhy?
Learning Shift
•
Broadcast
Linear Acquisition •
Instruction
•
Teacher-Centered •
Knowing Facts
•
School Ends
•
Teaching to the
•
Mean
• School as
Requirement
•
• Teacher as Sage •
•
•
•
•
•
•
•
Interactive
Hypermedia Learning
Construction
Learner-Centered
Learning-to-Learn
Lifelong Learning
Individualized Customized
School as Fun
Teacher as Guide
Tapscott
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Conventional Speed
Step-by-Step
Linear Processing
Text First
Work-Oriented
Stand-Alone
Connected
© 2004 Marc Prensky
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And finally …
• Net Gen 1982 – 1991? Or?
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•
•
•
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•
•
Oblinger 2005
Compose – online or longhand?
Memory – technology or paper?
Meetings – laptop – PDA?
Always connected? Cell? Internet?
Multitask?
Play video or computer games?
IM’ing is a verb?
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Tipping Points
• Ideas and products and messages and
behaviors spread just like viruses do.
……........the moment of critical
mass, the threshold, the boiling
point.………
Gladwell, 2000
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Multimedia Learning
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Exploration
Personalized Meaning-making
Individual Expression
Experimentation with Social Boundaries
Create Learning Trajectories
• Antiquated Classrooms
• Unprepared Faculty/Instructors
Gee et al 2005
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= Access
Seamless, articulated, collaborative, entry-level
nursing curricula, available anytime, anywhere;
Integrated, learning anytime, anywhere system for
delivering existing nursing curricula;
Competency-based, self-paced modules of existing
nursing curricula;
NEAC
Differentiated Entry Level Competencies – TBNE
Complies with essential standards & accreditation.
SACS – CCNE – NLN
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Clinical Experiences
Regional Clinical Associate Faculty –
SACS/CCNE/NLN
Regional Preceptors
TBNE Qualifications
Health Care Delivery System Partners
365 Days of the Year
24 Hours of the Day
Virtual Experiences
Airline Industry – High Reliability Organizations
99.99% Not Enough
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Course to Module Matrix
When modules listed under a course
are completed, course credit awarded
Last letter in module designation:
A = ADN & BSN required
B = BSN only required
First number in module designation:
1 = no eLine prerequisites
2 = eLine prerequisites
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eLine Collaborative
Central Enterprise Model
Institute of Academic Alliances - Great Plains
Interactive Distance Education Alliance
Recruit Nursing Education Programs
Survey Institutional Policies & Barrier Analysis
Price Analysis
Develop Policies, Procedures, By-laws &
Business Plans
Follow SREB Best Practices
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Integrity & Identity
“Unpack & Repack” Alliance Courses
Instructional Designer
Identity Branding with Alliance Member’s
Logos etc.
Weave Alliance Partner’s Theoretical ,
Conceptual or Pedagogical Framework(s)
Pervasive & Progressive Modular Threads
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Extramural Associate Faculty
105 Nursing Faculty
Non – local
Part-time , Non-tenure
Track
Credentials
SACS, TBNE, CCNE,
NLN
Yours, Mine & Ours!!
17,256 – 14,205
3,052 Available!
105 Nursing Faculty
Yours, Mine & Ours!!
29,278 MSN - Not
Employed in Nursing
7% of >2M
Advanced Practice
MSN/PhD
64% Employed in
Education
52.3% of Inactive RNs <
60
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Forward Through the
Rear-View Mirror
Marshall McLuhan
Your Charge – Plan
2!!
When will nursing
curricula be
delivered effectively
in other
configurations than
utilized now in the
classroom-patient
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room dyad model?
A Virtual Learning Space Project
Texas A&M University-Corpus Christi
Serious Games Solutions
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Revisit the Why? – U.S. Military
↓ Battlefield Fatalities
Improved Treatments
↑Combat Wounds > 12,000
Amputations
Kevlar Body Armor = New Pattern of
Complex Injuries
Survival – Bomb Blast; Gunshot; Shrapnel;
RPG; Mortars; Burns; MVA
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Program Information
Partners … to date
CDR Russ Shilling, Office of Naval Research
Paul Chatelier, Potomac Institute
Doug Whatley, CEO
Ben Sawyer
Jan Cannon-Bowers, University of Central Florida
Robert Stone, University of Birmingham, UK
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Program Description
Baseline/Background: Systems that
provide immersive, persistent,
asynchronous environments for
responsive education and training in
the medical & health professions,
military & civilian are lacking.
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Program Description
High-fidelity, first person learning
platform that dynamically responds to
real-world contextual inputs;
Authoring templates for incorporating
specialized learning objects into
modules to meet changes in job
competency requirements.
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Program Description
Cognitive experiential learning
platform;
Immersive virtual environment
mirroring the health care delivery
system;
Extensive modeling and simulation
capabilities yielding a suite of
customizable, self-contained software.
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Changing Times
Simulations … games
Fletcher
Concentrated reality; Dexter
Institute for Defense Analysis
Rehearsals for life;
Offer the promise of improved learning;
Best (military) training involves massive
amounts of practice with diagnostic feedback;
Selective fidelity < instructional objective
Practice … simulation …game
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Learning Theory & Video Games
Epistemic Frame –Ways of Thinking
Develop situated understanding;
Ways of Knowing, Doing, Being, Caring
Develop Effective Social Practices;
Experiment with Powerful Identities;
Develop Shared Values.
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Assessment &Evaluation Plan
“A Work in Progress”
Jan Cannon-Bowers (UCF)
Bob Stone (U/Birmingham, UK)
Measures & Metrics
Link Learning to Performance
Intention→Processes→Outcome
High-performance Visualization
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Key Program Milestones
Project Proposals
Contracting
Partnerships
Proof of Concept Cases
Post-Degree
Discipline’s Curricula
Case Storyboards
Complete
Accreditation
Standards, e.g. ACLS
SME Database
Pulse!! Advisory
Council
Assessment &
Evaluation Plan
Verification Measures
Validation Strategies
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Key Production Milestones
Concept Document
07/05
Design Documents
11/05
Risk Mitigation Documents
11/05
Preproduction Prototype
12/05
Platform Production – Code Complete
Alpha
Beta
Final
09/06
11/06
12/06
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Challenges to Date
Technical
Settling technology roadmap;
Smooth transition between
mathematical modeling layer &
visualization layer;
Ensuring user interface is not
disruptive to depicting
spatial/physical processes.
Programmatic
Maintain progressive &
pervasive curricula;
integrity & conformance;
Accurate pathophysiology;
Ensure pedagogical quality;
Matching schedules!!!!
SME’s
Location, location,
location
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Successes to Date
Clear assessment of innovation positioning;
Strong team recruited and contracted;
Studio @ TAMU-CC
Motion Analysis Hawki Digital Real-Time
Tracking System & Eagle4 Camera
Extension
Evaluation planning initiated
National Naval Medical Center!!!!!
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Relevance
Adaptable critical care continuum for changing
injuries in responses to the multiple results of
terrorism;
Better/faster care = Quicker return to duty;
Quickly author virtual education and training
curriculums that match the changing needs of
field medicine;
Interoperability of competency-based learning
modules;
Improved ‘OJT” - training reservists to meet
standards.
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Potential Benefits
Create new and/or update battle & trauma
response clinical skills;
Integrate lessons learned and experiences;
Rapidly generate highly specialized scenarios ‘just-in-time, 1st person’ learning;
Creates the space to 'see one, practice many, do
one, teach one' yielding decreased death and
injury rates for both the military and civilian
first responders.
Boyer 2005
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“Take Home Message”
The technology exists for providing military
medical learning systems with the greatest
capability ever available.
Being able to leverage this technology for
education, training, and aiding job performance
will save lives and maintain force readiness.
There is a need to couple opportunities provided
by technology with the policy and doctrine that
supports military medical health care
professionals.
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Design Funding
FIPSE – LAAP Program
eLine - $4M
Robert Wood Johnson
Foundation & Greater
Coastal Bend Consortium
Nursing Workforce:
Beyond 2000 - $1.25M
Telecommunications
Infrastructure Fund
Board
Model Classroom –
Web Infrastructure
Digital Media
Preceptorship
$1.8M
Office of Naval Research
$4.5M
Pulse!!
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Don’t tell me why it
can’t be done,
Show me how it can!
Jim Wright
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Contact
Claudia Johnston
Associate Vice President for Special
Projects
Texas A&M University-Corpus Christi
361-825-2712
claudia.johnston@tamucc.edu
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