Curriculum Development: Rehabilitation Nursing

Learning Needs and Characteristics

The rehabilitation nurses work long-standing in skilled nursing and rehab center where they are charged with the responsibilities of taking care of patients who are suffering from various types of injuries and illnesses (Jester, 2007, p. 3). These nurses have the responsibility of ensuring the patients recover from their medical conditions in the most comfortable way that can be achieved and that they get the required medication and specialized care needed. These rehab nurses also assist patients in living or coping with the disease or disability (Joel, 2002, p. 67). They, therefore, work with both inpatient and outpatients. Because of the nature of the work, rehab nurses usually go for further specialization in rehabilitation besides the same education and training they receive as other registered nurses.

Nurses have some unique learning requirements for their job. The rehabilitation nurses need to be trained on how to handle fragile patients because they usually work with chronically sick patients or patients with disabilities. Those registered nurses (RNs) who wish to venture into a long-term rehab center to specialize in rehabilitation nursing are welcome for on-the-job education as they pursue their career dreams (Joel, 2002, p. 67). Nursing education is being faced with a great challenge as the demand for nurses increased very fast alongside advancing technology and developments of new knowledge, abilities and skills. These must be balanced so as to give the nurses quality education for their job responsibilities.

Outcome Objectives

Rehabilitation nursing education is crucial in nursing profession because it will lead to well-prepared nursing staff to deal with the demands of the rehabilitation center (Jester, 2007, p. 5). After going through the education program, it is anticipated that the nurses will be able to apply information technology skills, critical thinking when contorted with particular medical conditions (Hoeman, 2007, p. 16), demonstrate extensive ability to integrate pathophysiology of various conditions, and to apply evidence-based practice in their daily duties.

The rehabilitation services will be taught as independent courses and rehabilitation nurse educators will be used so that there is a good matchup of the learning needs and instruction process (Jester, 2007, p. 6). These faculty member educators will tutor didactic courses, promote faculty-student nurse interaction and teach clinical practicum all of which precipitate the best service delivery.

The program will help the nurses to learn new skills and attain new knowledge that is focused on the identified learning needs (Jester, 2007, p. 12). Most of the education and training provided in a long-term rehab center is set to address specific needs through such could face some serious barriers.

At the end of the education program, nurses will be able to offer medical rehabilitation services to most of the presenting cases encountered on daily basis in a professional manner (Fitzpatrick et al, 2010, p. 63). The training will be based on the outcomes of the research on threshold knowledge where nurses indicate the areas that require specialized training.

Evaluation Levels

Evaluation is very critical for this nursing education program for rehabilitation nurses. As nurses, there is a need to evaluate everything that is used in service delivery like the evaluation of interventions to determine their efficiency (Fitzpatrick et al, 2010, p. 63). The nurse faculty members must complete their educational preparation program by successfully finishing all the modules and minimum hours for the classes or sessions (Fitzpatrick et al, 2010, p. 63). This program shall use a five model to evaluate the progress of the nurses and is it is set to give very accurate and valid evaluations of the progress the nurses would have made at each stage;

• 1^st module – measure definitions, terms related to rehabilitation nursing
• 2^nd module – measure cognitive and affective development
• 3^rd module – measure subjective and objective principles in rehabilitation nursing
• 4^th module – measurement of the clinical rehabilitation ethical and legal issues
• 5^th module- measure the use of clinical standers in simulated clinical circumstances

There will be directions to guide the process of evaluation and the nurses will be graded based on the completion of courses under the program.

Teaching Methods and Evaluation Methods

Teaching will take place at different levels and will involve a number of activities that would be formal or informal but relevant for rehabilitation nursing. Formal teaching will include the use of lectures and group discussions (Hoeman, 2007, p. 16). Some lecture could be informal but planned to stimulate critical study among nurses.

The informal education methods will incorporate counseling and anticipatory guidance. The nurses learning new skills are prepared for future duties and development, even though this requires the teacher to be well prepared for the class, presentation is not always defined (Fitzpatrick et al, 2010, p. 93). Four teaching methods will be used and they include;

1. Lectures
2. Roleplaying
3. Group discussions
4. Demonstration and simulation

Lectures

The skilled nursing and rehab center can at times present information t a group of nurses as lectures and this is the most effective and formal way of information presentation (Fitzpatrick et al, 2010, p. 93). Nonetheless, the lectures usually tend to create a passive learning setting. The educators will however use the following means to capture the attention of the nurses.

1. The educators will use computer slide projections and overhead projections.
2. Engaging students in question and dissection session
3. Distribution of printed handout notes to reinforce the lecture points

Discussions

Since the students for this program will be adults, their attention span is slightly shorter than college students as such there will be discussion sessions where two-way communication will prevail (DeYoung, 2009, p. 132). Reciprocal information sharing is important and will present a chance for the nurses to ask questions, contribute in giving answers, make comments and receive their feedback (Fitzpatrick et al, 2010, p. 96).

Two-way communication is an important feature of the learning process. Learners need an opportunity to raise questions, make comments, resound out loud, and receive feedback to develop an understanding (Fitzpatrick et al, 2010, p. 97). The nurses will learn from one another and the nurse educator as well. To be more fruitful, the discussions will be organized on specific pertinent topics.

Demonstration

The educators will use demonstration skills like psychomotor skills together with discussion and explanations and also provide time for the students to perform (DeYoung, 2009, p. 132). This teaching strategy gives student nurses the sensory pictorial impression of how certain skills are performed. A demonstration is done in front of the students so that they can have good visual and auditory perception (Spencer, 2003, p. 592). The same equipment that will be used for real practice is the one used for demonstration to ensure that the learners are well acquainted with the equipment and processes.

Role-Playing

Making the learners assume the role of the professionals they are training to become is very effective in maximizing the learning process. The rehabilitation nurses offering guidance and counseling would find it very profitable and educative when they put themselves in the role of the patients receiving rehab care (Spencer, 2003, p. 592); their care and several ways of responding to the treatment session and feeling can become apparent.

Another strategy would be to rehearse the roles like a counseling nurses can effectively develop their communication and listening skills. This will greatly build their communication skills hence enabling them to be good practitioners (Spencer, 2003, p. 592). Role-playing is beneficial because it puts the learners in the shoes of the patients and professionals in a situation that can probably occur giving them a chance to learn crucial skills without risking patients’ health or doing it at the expense of clients (DeYoung, 2009, p. 132).

Evaluation Methods

Evaluation methods are very important just as the teaching methods and they are set to assess whether the program met its objectives or not. If it does meet the goals, then to what degree were the objectives satisfied (DeYoung, 2009, p. 135). Five methods will be used for assessing the progress of the learners towards the program goals and effectiveness of the teaching methods and possible future nursing needs in the rehabilitation practice (Spencer, 2003, p. 594).

• Written tests: evaluators often administer a written test on occupational especially rehabilitation nursing knowledge in a classroom environment to assess the skills, abilities, knowledge and aptitude of the learners. The test will be administered on a computer or paper and it would be a combination of multiple-choice questions and essays (DeYoung, 2009, p. 135). The goal of these tests will be to measure whether the learner learnt the job-related knowledge fast enough or not. As such, the questions will be drawn from the specific education material used for teaching and the learner will not be given specific material to study for the tests.
• Clinical Teaching: this is an interpersonal way of communication in professional nursing between an educator and a learner. There is usually a dynamic interrelationship that develops. The teacher should be able to use the role of the teacher, the role of the learner, external influence and the role of the interaction that takes place (Spencer, 2003, p. 594). The evaluator will use this to test the learner understanding of clinical processes like the diagnosis; patient care issues like discretion and confidentiality among other things through actual practice. The educator will be a role model, demonstrator, supervisor and mentor (DeYoung, 2009, p. 138).
• Presentation: The class presentations are used for the assessment of the learners as an individual and how they stand out from the crowd. This method evaluates the knowledge and skills that the learner obtained and how he/she can communicate them orally and demonstrate what is happening as well. The evaluator assesses the ideas, emotions and information communicated from the presentation (Spencer, 2003, p. 594). The most common form of presentation has been PowerPoint accompanied by explanation or discussion from the learner doing the presentation.

In doing the evaluation, the evaluators first assess the content to determine what the student demonstrated to have learnt, second, they assess the communication and how effective was the communication in terms of conciseness, eloquence and coherence. Finally, the evaluator judges the overall presentation and its effectiveness in demonstrating that learning took place.

• Project Work: this is a way of allowing people to improve their learning skills by doing practical jobs independently but under the guidance and direction of educators. This is more like a ‘takeaway’ assignment but it has to be on a public health topic (DeYoung, 2009, p. 139). The learner can choose topics of their interest and then do research and finally a project on these topics (Spencer, 2003, p. 594). The evaluator can grade the project as if it was a lab assignment if it was done by a group of learners. Sometimes the evaluator can grade the ability of the student to do project work by analyzing the accuracy, validity and quality of individual learner projects.

A Lesson Plan

1. Curriculum Area: Skilled Nursing and Rehab Center.
2. General Information:
   • Subject: Rehabilitation Nursing.
   • Level: Postgraduate Students.
   • Trainees: Nurses attending Clinical rehabilitation next semester.
   • Topic: Ethical issues and Handling unusual medical conditions.
3. Title of the Lesson: Taking Charge and Managing Ethical Issues Appropriately
4. Content Outline:
   • Application of Nursing process;
   • Ethical decision making;
   • Patient safety concerns;
   • Advance directive;
   • Evidence-based practice;
   • Culturally competent care;
   • Life ending decision;
   • Application of rehabilitation scope;
   • Standards of care;
   • Communication process;
   • Nursing diagnosis and the nursing process;
   • Patient-centred care.
5. Education Needs and Rationale for Lesson: Two major ways have been very commonly used by rehabilitation nurses in education. The first way is the theory reading where they study books, journals and other literature concerning a subject of interest. The second way is the practical encounter in the hospital setting. The major concern for this education is that there seems to be a gap between theory and the actual nursing practice. Participation in a class where the hospital clinical cases and hospital environment is simulated will provide proper preparation for a student for real clinical incidences. The simulation will even reduce the nervousness that can develop among the learners who are scared about the real hospital environment. A big concern with learners venturing into rehabilitation nursing is that they fail to know how to act or behave when faced with a certain types of situations that are not addressed in theory and are therefore deemed awkward or troubling. These nurses need to learn and understand the ethical issues surrounding the rehabilitation nursing field (Hoeman, 2007, p. 36). How to how reach when a patient does for instance make sexist comments, how to comfort a child recovering from surgery or how to pass bad news to patients like the real bad medical outcome. These are some of the things that nurses in the rehabilitation nursing field have to be comfortable with. Such scenarios will be simulated by use of second life to help them study before they happen in the real hospital setting.
6. Learning Prototype:
   • Role-Playing: The new rehabilitation nurses will be given a chance to role-play particular incidences that are bound to happen in a hospital setting. One of the nurses will act out the incident like a patient refusing to take medication, or a patient threatening to sue the hospital and the nurses or a patient who won’t just take food but keeps throwing it. Numerous incidences can be role-played by the learners and then the other student will respond with the correct actions and measures to manage the situation.
7. Learning Objectives:
   • The student will:
     • Be taught how evade certain negative clinical incidences.
     • Understand the proper response to inappropriate patient behavior.
     • Be at ease when handling clinically critical situations.
     • Learn self-control and calmly take charge of a threatening situation.
     • Be better equipped emotionally and skillfully forthcoming clinical experience.
8. Location: xxxxxxxx Hospital of the FutureThis location is very unique and it will be the most appropriate for training nurses because it can replicate different areas of a hospital setting. The setting from the reception area to the ward and treatment, the nurses will feel that actually they are experiencing the real thing.
9. Instructions / Procedure:
   1. Before the class begins, the learners will be given hand-outs in advance of the roles they will play. However, they will be grouped in twos or threes depending on the sentences.
   2. The learners will meet in SL and at xxxxx hospital.
   3. The learners will take turns to act out their roles as grouped while the others will respond to the incidences. 5-15 minutes will be given for each role to be played.
   4. The educator will move around among the groups collecting their responses to the current incidence and offer appropriate guidance as necessitated.
10. Evaluation Strategies:
    • The educator will move around assessing each groups taking notes and collecting their responses as the groups had noted down as their observation. The nurse educator will then observe each learner as he/she plays a role.
    • The educator will review notes taken and the grading given in the next class.
11. Adaptations: The nursing student will be taken through an introduction course on SL before beginning the study. The computer laboratory assistant will set up the lab for this class plus, there will be IT personnel during the class to help in any technical hitches. The educator will encourage the student to install SL to their home computers so that they can work with it and become more familiar with it for future classes.
12. Anticipated challenges: Nursing students do not have a strong technical background and therefore understanding the navigation through the computer could be challenging. The learners could find the use of SL challenging.

Reference List

DeYoung, S. (2009). Teaching Strategies for Nurse Educators, (2^nd Ed). NJ: Prentice Hall: Upper Saddle.

Fitzpatrick, J. J., Shultz, C., & Aike, T. (2010). Giving Through Teaching: How Nurse Educators Are Changing the World. London: Springer.

Hoeman, S.P. (2007). Rehabilitation Nursing: Prevention, Intervention and Outcomes. London: Elsevier Health Sciences.

Jester, R. (2007). Advancing Practice in Rehabilitation Nursing, Oxford: Wiley-Blackwell.

Joel, L. (2002). ‘Education For Entry Into Nursing Practice: Revisited For The 21^st Century.’ Online Journal of Issues in Nursing, 7(2). Web.

Spencer J. (2003). Learning and Teaching in the Clinical Environment. BMJ, 326: 591-94.