Running head: CLASS SESSION
Developing a Class Session in Psychopharmacology
Erin Kibbey
Ferris State University
1

CLASS SESSION
Abstract
The focus of this paper is on the development of a lesson plan that will be used for the creation
2 of a class session taught to undergraduate psychiatric-mental health nursing students on the topic of psychopharmacology. To this end, this paper includes rationale for the chosen topic of psychopharmacology, chosen class objectives, student assignments in preparation for the class session, organization of content, teaching methods and resources, evaluation of student learning, and evaluation of instruction. The lesson plan itself, an outline of the content chosen for the class session, an example of a classroom assessment technique, and a handout are also included for reference.

CLASS SESSION 3
Developing a Class Session in Psychopharmacology
With the prevalence of mental illness reaching about one quarter of adults in a given year, mental health nursing can be seen as an important subject for students to learn in nursing school
(Kessler, Chiu, Demler, & Walters, 2005). Thus, learning about the subtopic of psychopharmacology as an interventional strategy to help patients with psychiatric illnesses can also be seen as vital. The purpose of this paper is to discuss the preparation and rationale involved in designing a lesson plan and subsequent class session for undergraduate nursing students on the topic of psychopharmacology.
Topic
As previously mentioned, the statistics related to the prevalence of mental illness are staggering. Since psychopharmacology is a primary treatment mode of mental health nursing care, this subtopic is of obvious importance for nursing students to understand. Nurses must be able to recognize how these medications work in order to monitor patient response, teach patients about their medications, and provide safe and effective care (Trigoboff, 2013). In addition, pharmacological therapies and nursing care related to the administration of pharmacological therapies are tested on the National Council Licensure Examination for
Registered Nurses (NCLEX-RN) (National Council of State Boards of Nursing, 2013). Thus, there are several reasons the topic of psychopharmacology should be considered essential learning material for nursing students.
Development of Class Objectives
For this lesson plan, five class objectives were constructed (see Appendix A). Objectives and outcomes specify what students should know, do, and value; they also determine how students will be graded (Billings, 2012). The first step taken in developing the objectives for this

CLASS SESSION lesson was determining the major content areas that the objectives should be based on.
According to Billings and Halstead (2009), it is important that content is considered a value to
4 the student and essential to the core curriculum. Thus, in order to determine some of the most important content areas to be included in the objectives, the guidelines developed by the
Psychiatric Mental Health Substance Abuse Essential Competencies Taskforce of the American
Academy of Nursing Psychiatric Mental Health Substance Abuse Expert Panel (2012) were utilized. Accordingly, these guidelines were designed to prepare nurses at various education levels to provide safe and effective care of the mentally ill and those at risk. Hence, the last three objectives were created based on a conglomeration of the essential content areas and learning outcomes noted in these guidelines (see Appendix A).
The other content areas included in the class objectives came from suggestions in an article by Bonnivier and Magoteaux (2012). In this article the authors found that students trying to absorb the large amounts of content regarding psychopharmacology did not always grasp the foundational concepts related to this topic, such as explanations for why medications are not always an effective treatment plan. Thus, objectives one and two were constructed to incorporate concepts related to the understanding of foundational concepts including the historical evolution of mental illness treatment associated to psychopharmacology as well as the challenging factors associated with ineffective treatment (see Appendix A).
The second step in constructing the class objectives was to determine the level and domain of thinking and learning desired for each objective content area. Each of the objectives were created using various taxonomy guides. Using the taxonomy classifications, objectives were created that focused on the three domains of learning including the cognitive, affective, and psychomotor. The cognitive domain is defined as the knowledge, skill, comprehension, and

CLASS SESSION 5 evaluation (Baker, Grooms, Rovai, & Wighting, 2009). All of the objectives, with the exception of objective number two, were written to reflect learning from at least the cognitive domain (see
Appendix A).
However, the cognitive domain is only one aspect of learning. The affective domain includes values, beliefs, feelings, and emotions (Baker et al., 2009). In the field of nursing, especially mental health nursing, being aware of one’s values and acting in accordance with those values is very important. According to Saunders (2003), the true nature of nursing requires educators to consider learning in the affective domain. Thus, constructing some objectives that incorporated this domain was also deemed important. Objectives one and two were designed to incorporate this element of learning (see Appendix A). Finally, the psychomotor domain utilizes physical skills as well as transferable skills that are needed (Baker et al., 2009). Objective number four incorporates this part of learning in addition to the cognitive domain (see Appendix
A).
Finally, the last consideration in the development of learning objectives was whether or not they were written in a way that could guide the content for the lesson and evaluation strategies. According to Saunders (2003), objectives should be broad enough to guide the learning process but not be so specific that it hinders creativity and critical thinking. In addition, ten characteristics of well-developed objectives were also noted by Saunders (2003), some of which include: objectives that refer to all three domains when possible, written at the highest level of performance expected, and include only one verb. I believe the five objectives included in Appendix A took these considerations into account and were written accordingly.
Assignments
The student assignments in preparation for the class session were designed to provide

CLASS SESSION students with the necessary foundational knowledge about psychopharmacology through the
6 assigned textbook readings and YouTube video as well as a condensed preview of essential pharmacology content through the use of a handout (see Appendices A and B). Since the topic of psychopharmacology has been reportedly overwhelming due to the amount and complexity of material, the use of a handout found in an article by Bonnivier and Magoteaux (2012) was used to aid in the learning of the content. According to Sakraida and Draus (2005), handouts are considered beneficial for organizing content, consistently receive positive feedback from students, and can serve as an adjunct to lecture and discussion methods. Since the class session this lesson plan was designed for only allows 15 minutes of face to face time with students, this handout was assigned to provide these benefits while still including essential core content that is usually difficult for students to learn.
In the article by Bonnivier and Magoteaux (2012), textbook readings and the YouTube video were two other strategies used to improve student understanding of psychopharmacology.
It was noted that the textbook provided basic coverage of nursing content and the video included information about movement disorders and symptoms, the challenging choices patients must often consider in the decision to take their medications, and the stigma of mental illness (2012).
I believe the assigned video also makes the content more humanistic through capturing the lives of real people inflicted with mental illness. In the class session, I plan to bring up this video as a way to stimulate a brief class discussion in order to help achieve desired objectives. In addition, the use of these assignments have received positive student feedback and course grade improvements according to Bonnivier and Magoteaux (2012).
Organizing the Content
Once the topic and objectives for the lesson plan were created, the next step in

CLASS SESSION developing a class session on the topic of psychopharmacology was to create an outline to organize the content (see Appendix C). According to Saunders (2003), an outline forces the
7 educator to consider the organization and flow of ideas for a class session; outlines also flow directly from the objectives. So, in order to create an outline, I first familiarized myself with the content related to psychopharmacology included in the textbook Contemporary psychiatricmental health nursing . Once again, I also took into consideration the article by Bonnivier and
Magoteaux (2012) related to innovative teaching strategies for pharmacology in mental health nursing by moving from teaching content to teaching concepts. After broadly reviewing the literature related to psychopharmacology I was able to construct an outline that flowed from the objectives and considered the essential content and how it all fit together.
Teaching Methods and Resources
The next concern in developing a class session was deciding the teaching strategies that would be implemented to facilitate learning of the stated objectives. One important consideration is that within a classroom, one learning style may not be suited to every student.
Therefore, a variety of teaching strategies are usually needed to provide support to various learning styles (Billings & Halstead, 2009). In addition, although a student may have a preferred learning method, exposure to multiple teaching methods can challenge the student to think outside of the box (2009). For this class session, teaching strategies were developed to promote the desired learning objectives whilst considering the content, my teaching abilities, and the learners themselves. To this end, it was felt that lecture with the use of a PowerPoint presentation would be the most appropriate strategy and thus the most emphasized method. As previously mentioned, I will also refer to the pre-class assignment of the YouTube video in order to promote active learning through a brief class discussion. Finally, a few sample questions

CLASS SESSION during the presentation to elicit feedback and active participation will also be a utilized teaching
8 strategy to achieve desired learning objectives.
Since lecture is considered useful in clarifying complex, confusing, and new content this was the main teaching strategy chosen to deliver concepts and content on the topic of psychopharmacology (Rowles, 2012b; Saunders, 2003). Lecture is a form of passive learning requiring students to use their senses to acquire knowledge from lecture, reading, or visual media
(Billings & Halstead, 2009). However, I do plan to promote active engagement throughout the presentation through the use of previously mentioned strategies. Another benefit of the lecture as a teaching strategy is that students often prefer a passive learning method, as it is what they have been socially exposed to and currently dominates nursing education (Billings & Halstead,
2009; Tedesco-Schneck, 2013). Moreover, lecture can be considered a more comfortable teaching strategy for most novice educators, like myself. Disadvantages of this method can include decreased student involvement if other teaching methods are not implemented as well as the lengthy amount of time required to prepare for lecture presentations on behalf of the educator
(Rowles, 2012b).
Although passive learning and lecture has its advantages, it often lacks cognitive effort or the required use of higher cognitive skills (Billings & Halstead, 2009). For this reason, I plan to incorporate strategies such as discussion and questioning that require the use of active learning methods. Active learning is defined as using participation and exploration throughout all stages of the learning process and has been shown to increase critical thinking skills and participation
(Billings & Halstead, 2009; Tedesco-Schneck, 2013). I am hoping a discussion related to the prior assigned YouTube video will also provide a way to deal with emotional content and allow students to see patients with clinical issues related to psychopharmacology before they encounter

CLASS SESSION them in the clinical setting. Although active learning also has its advantages, students may have
9 trouble adapting to new ways of learning and may not be prepared to answer questions or be active in class discussions due to insufficient knowledge (Rowles, 2012b).
Evaluation of Student Learning and Evaluation of Instructor
The last stage in developing a lesson plan for a class session is determining evaluation methods. This should be a twofold evaluation, considering evaluation of student learning or outcomes and evaluation of the instruction or the process (Saunders, 2003). One way to evaluate student learning and teaching during a class session is through the use classroom assessment techniques (CATs). This type of evaluation method provides immediate feedback about the teaching-learning process and allows students to be more involved in their learning (Rowles,
2012a). In order to evaluate the comprehension of major class objectives and my teaching, I plan to implement a 1-minute paper at the end of the session (see Appendix D).
Evaluation of learning outcomes can also occur through other methods. Generally it is through performance on an assignment or written examination and performance in the clinical area (Saunders, 2003). One way I could evaluate student learning of objectives from the class session is through a brief post-class exam. Another evaluation technique could include the use of a post-class one-on-one role play where the student plays the role of a nurse and the instructor plays the role of a mentally ill patient and has to develop a teaching plan to help the patient’s chances of adhering to the medication regimen.
According to Saunders (2003), evaluation of instruction or the educational process can be done formally or informally. Informal examples might include remarks from a student or students during the class session. Formal evaluation forms administered to students are often used by institutions at the end of a course in order to solicit feedback on various criteria (2003)

CLASS SESSION 10 and could be another way to receive instructor feedback. It has been shown that student ratings are considered highly reliable as well as positively correlated with student achievement, however, there remains challenges with the validity and reliability of the instrument used to evaluate teaching effectiveness (Hayes, 2011). My own reflection and self-evaluation could also be another form of evaluation related to the learning process. Finally, evaluation from faculty, such as Michelle, could be another resource for evaluation of instruction.
Conclusion
As previously mentioned, psychopharmacology is an important topic for nursing students to understand. This paper has discussed the development and rationale of a lesson plan that will be used to guide a future class session on this important topic. Included in this paper was the reasoning behind why psychopharmacology was chosen as a topic; the development of class objectives guiding the class session and lesson plan; assignments chosen to prepare students for the class session and why they were chosen; an outline detailing how the content will be organized for the class session; teaching strategies that will include lecture, discussion and questioning and the rationale behind their use; and finally methods that will be used to evaluate both student learning and me as an instructor.

CLASS SESSION
References
Baker, J. D., Grooms, L. D., Rovai, A. P., & Wighting, M. J. (2009). Development of an instrument to measure perceived cognitive, affective, and psychomotor learning in traditional and virtual classroom higher education settings. The Internet and Higher
11
Education , 12 (1), 7-13.
Billings, D. M. (2012). Developing leaner-centered courses. In D. Billings & J. Halstead (Eds.),
Teaching in nursing: A guide for faculty (4 th ed.). (pp. 160-169). St. Louis, MO: Elsevier
Saunders.
Billings, D., & Halstead, J. (2009). Teaching in nursing: A guide for faculty (3rd ed.).
Philadelphia, PA: W. B. Saunders.
Bonnivier, J. F., & Magoteaux, A. L. (2012). Innovative teaching strategy for pharmacology in psychiatric-mental health nursing: Moving from content to concepts. Journal of
Psychosocial Nursing & Mental Health Services, 50 (12), 22-29. doi: http://0-dx.doi.org.libcat.ferris.edu/10.3928/02793695-20121107-03
Hayes, J. (2011). Student evaluation of teaching. In M. Bradshaw & A. Lowenstein (Eds.),
Innovative teaching strategies in nursing and related health professions (5 th
ed.). (pp.
563-574). Sudbury, MA: Jones & Bartlett Publishers.
Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey
Replication (NCS-R). Archives of General Psychiatry, 62 (6), 617-627. doi: 10.1001/archpsyc.62.6.617
Kneisl, C. R. & Trigoboff, E. (2013). Contemporary psychiatric-mental health nursing (3rd ed.).
Upper Saddle River, NJ: Prentice Hall

CLASS SESSION
National Council of State Boards of Nursing. (2013). 2013 NCLEX-RN® Detailed Test Plan:
12
Item Writer/Item Reviewer/Nurse Educator Version. Retrieved from https://www.ncsbn.org/2013_NCLEX_RN_Detailed_Test_Plan_Educator.pdf
Psychiatric Mental Health Substance Abuse Essential Competencies Taskforce of the American
Academy of Nursing Psychiatric Mental Health Substance Abuse Expert Panel. (2012).
Essential psychiatric, mental health and substance use competencies for the registered nurse. Archives of Psychiatric Nursing, 26 (2), 80-110. doi: 10.1016/j.apnu.2011.12.010
Rowles, C. J. (2012a). Improving teaching and learning: Classroom assessment techniques. In D.
Billings & J. Halstead (Eds.), Teaching in nursing: A guide for faculty (4 th
ed.). (pp 285-
290). St. Louis, MO: Elsevier Saunders.
Rowles, C. J. (2012b). Strategies to promote critical thinking and active learning. In D. Billings
& J. Halstead (Eds.), Teaching in nursing: A guide for faculty (4 th ed.). (pp. 258-284). St.
Louis, MO: Elsevier Saunders.
Sakraida, T., & Draus, P. (2005). Educational innovations. Quality handout development and use. Journal of Nursing Education, 44 (7), 326-329.
Saunders, R. (2003). Constructing a lesson plan. Journal for Nurses in Staff
Development, 19 (2), 70-80.
Tedesco-Schneck, M. (2013). Active learning as a path to critical thinking: Are competencies a roadblock? Nurse Education in Practice , 13 (1), 58-62.
Trigoboff, E. (2013). The science of psychopharmacology. In C. R. Kneisl & E. Trigoboff
(Eds.), Contemporary psychiatric-mental health nursing (3 rd
ed.). (pp. 113-138). Upper
Saddle River, NJ: Prentice Hall

CLASS SESSION
Appendix A
Lesson Plan
Topic

Psychopharmacology
Class Objectives
1.
From a historical perspective, reflect on how psychopharmacology has changed mental health nursing.
2.
Explore why patients may refuse or not follow treatment plans (e.g., non-adherence).
3.
Illustrate the neurobiological mechanism for various psychotropic medications.
4.
Construct a teaching plan to help patients manage their medications and increase adherence.
5.
Explain the primary clinical indications, major side effects, and significant nursing implications for each of the drug categories.
Student Assignments

Read chapters 7 & 31 from your textbook Contemporary psychiatric-mental health nursing by Kniesl and Trigoboff (2013).
 Watch YouTube video on movement disorders associated with psychopharmacology.

Review drug handout (see Appendix C).
13

CLASS SESSION
Appendix B
Psychopharmacology Handout (Bonnivier & Magoteaux, 2012)
14

CLASS SESSION 15

CLASS SESSION 16

CLASS SESSION 17
Appendix C
Outline
I. Psychopharmacology - Concepts
A.
Why tx of mental illness can be so challenging
1.
Historical look at tx of mental illness in America a.
Neurobiological basis for psychopharmacology
2.
Deinstitutionalization & inadequate community follow-up care
B.
Nonadherence
1.
Discusss YouTube video
2.
Debilitating side effects, high costs of medications, toxicity, stigmas, & “broken brain syndrome”
3.
Strategies to promote adherence
C.
Nursing implications - Questions
II. Essential core psychopharmacology - Content
A.
Potential adverse effects
1.
Anticholinergic delirium
2.
Agranulocytosis
3.
Neuroleptic malignant syndrome
4.
Extrapyramidal symptoms
5.
Steven Johnson syndrome
6.
Tardive Dyskinesia
7.
Signs of metabolic syndrome
8.
Serotonin syndrome.
9.
Hypertensive and hypotensive crises
B.
Psychopharmacological handout – Brief Review
C.
Antipsychotic agents
1.
Atypical (2 nd
generation agents) a.
Common side effects b.
Life threatening potential
2.
Typical (1 st
generation agents) a.
Common side effects b.
Life threatening potential
3.
Drugs to tx side effects of antipsychotic agents a.
Anticholinergic agents b.
Antihistamine agent c.
Dopamine agonist agent
D.
Antidepressent agents
1.
Selective serotonin reuptake inhibitors a.
Common side effects b.
Life threatening potential
2.
Serotonin norepinephrine reuptake inhibitors a.
Common side effects b.
Life threatening potential
3.
Norepinephrine dopamine reuptake inhibitor

CLASS SESSION a.
Common side effects b.
Life threatening potential
4.
Alpha-2 antagonist agent a.
Common side effects b.
Life threatening potential
5.
Serotonin-2 antagonist reuptake inhibitor a.
Common side effects b.
Life threatening potential
6.
Tricyclic antidepressant agents a.
Common side effects b.
Life threatening potential
7.
Monoamine oxidase inhibitors a.
Common side effects b.
Life threatening potential
E.
Anxiolytic agents
1.
Benzodiazepines a.
Common side effects b.
Life threatening potential
2.
Non-benzodiazepines a.
Common side effects b.
Life threatening potential
F.
Mood-stabilizing agents
1.
Antimania agent a.
Common side effects b.
Life threatening potential
2.
Anticonvulsant agents a.
Common side effects b.
Life threatening potential
3.
Anticonvulsant agents (off-label, adjunctive use) a.
Common side effects b.
Life threatening potential
4.
Atypical agents a.
Common side effects b.
Life threatening potential
G.
Medications for substance abuse
1.
For ETOH withdrawal a.
Benzodiazepines b.
Anticonvulsant agent – Carbamazepine (Tegretol)
2.
ETOH antagonist agent a.
Common side effects b.
Life threatening potential
3.
ETOH abstinence maintenance a.
Common side effects b.
Life threatening potential
4.
Opioid antagonist agent a.
Common side effects
18

CLASS SESSION b.
Life threatening potential
5.
Narcotic antagonist agent a.
Common side effects b.
Life threatening potential
6.
Opioid substitution agents a.
Common side effects b.
Life threatening potential
H.
Drugs to treat ADD/ADHD
1.
Stimulant agents a.
Common side effects b.
Life threatening potential
2.
Nonstimulant agent a.
Common side effects b.
Life threatening potential
I.
Alternative medicine approaches
1.
Herbals, minerals, & vitamins
2.
Other alternative tx’s
19

CLASS SESSION 20
Appendix D
Classroom Assessment Technique
I have modified an example by Angelo and Cross (1993) (as cited in Rowles, 2012b).

Implementation of the 1-Minute Paper
Implemented When : At the end of class
Purpose : To assess comprehension of major course concepts
Activity
: On a maximum of half a page, the students will answer “What was the most important thing learned in this class session?”
Time Involved : 2 minutes for administration, evaluation of answers will occur after the class session and sent to students later
Advantages : Little class time used, minimal time needed for analyzing the results, students think about their learning
Disadvantages : Results can depend on asking question correctly