Journal 2 Ackerly

Week One
The first week of my practicum was an eye opening experience which will be
explained in detail. My very first classroom experience I was able to cover the class
for students to have access to an instructor in preparing group health fair
presentations on April 24, 2018. My preceptor and I had decided at our meeting I
would develop the class activity for delivery of information technology (IT) content as
a practicum requirement of my LC in the classroom. This content had previously been
a dry topic or delivered by a guest speaker. Our SUNY Delhi School of Nursing (SON)
associate degree in nursing (AND) program has been investigating simulated electronic
health record (EHR) programs for use in labs and classes. After a faculty
demonstration, one publisher sent a sample for us to trial. As I was looking through
the sample, I found it had capabilities beyond what was included in the live
demonstration. There was a complete scenario simulation activity which I was able to
figure out how to navigate and present as an interactive classroom activity. Preparing
the class for the practice activity included a discussion about meaningful use and
implementation of EHRs from their assigned reading in Cherry and Jacob (2014). The
students participated in the EHR simulation as we navigated the charting, assessment
tools and documents within the system together. The EHR stimulated a lively
discussion related to decision making and privacy mandates. The students were
interested in the topic, as they are about to embark on transfer of the knowledge to
their professional practice. As a bonus, the students provided feedback on this trial
system that they liked this EHR system.
Grading Student APA Papers
Week one also included co-grading student 4-6 page APA papers. When my
preceptor and I talked about the papers we discovered I likely had a higher comfort
level with APA than she currently did, though I do not claim to be an expert by any
means. We agreed in comparing our grading of a few papers I had graded and
submitted for her review and our scores for grades were very similar. We had the
same ideas in mind with grading following the rubric; a) exposure to writing is
extremely limited, b) they do not have APA manuals to refer to, c) time with a tutor
was limited to a 1 hour mandated session at the campus library or STAR-NY (2018)
online to review their paper. Our congruence on how to level grades was when she
proposed I would provide feedback to all 20 students related to the APA in their
papers. Based on my feedback to students and her review, she would provide the
grades.
As I provided feedback to each student using track changes, it became evident
they were all making the same types of errors in formatting in-text citations and
reference lists. Though I was able to provide feedback related to use of first person,
scholarly tone, and use of colloquial expressions, the majority of the errors were in
formatting and referencing. I discussed the issue with my preceptor as we reviewed
the grades. We discovered the students who had a face to face meeting with the
writing tutor performed somewhat better on their APA use. I proposed a meeting
with the director of the writing center and with support from my preceptor, I met
with the director and explained our findings of the APA paper issues. This meeting
contributed to greater understanding of what the students were provided from the
writing tutors. In fact the paper content, not APA was the focus for both on ground
and online tutors which was informative to the writing center director and our ADN
program. The focus of the tutoring was evident as the content of the papers was
reasonably well stated in most papers. This finding was shared with my preceptor and
may invoke an impetus for change in earlier APA preparation of ADN students for
advancing their education. It is important for nursing students to develop writing
skills as Jefferies, McNally, Roberts, Wallace, Stunden, D'Souza, and Glew (2018)
report. These skills will increase self-confidence in pursuit of higher education and
improve comprehension. Communication and critical decision making are also
enhanced with advancement of literacy skills early in nursing education.
I have offered a basic APA workshop to interested students on April 26, 2018.
They are excited and my preceptor is enthusiastically supportive of the idea. Though
I had not anticipated this much work in week one, it was an extremely valuable
learning experience for me, my preceptor, the writing center, and the students. I
would not have been able to identify the need for investigation of how students APA
writing skills were being supported without having access to each of the 20 student
papers.
Proctoring a Nursing Examination
I was able to proctor exam two for NURS 265 class. I had access to the exam
prior to proctoring which allowed my careful review of each question. This activity
was critical in the event students had questions related to how an item on the exam
was presented. In my review I felt the exam was well written and in my recall of
course content and reading assignments every question had been covered. During the
exam however, several students acme to me with a question about an alternate
format item which was incompletely labeled. In looking at the exam, my eye did not
catch this in my review as the answer to the question was obvious to me. I could not
provide an affirmative answer during the exam and my preceptor and I discussed this
after the exam. Oermann and Gaberson (2014) support P-value test items of .30-.70
as optimal test items. The item in question on the exam fell into this range in theory,
but the students did not fare well at all with less than desirable D-value for the same
item. She gave students consideration for the item as not a valid test item as it was
in fact an incomplete question.
Service
 The SON held the annual External Advisory Council Meeting which I attended on
March 29, 2018. Topics included the new SON leadership structure, BSN in 10
legislation, and marketing discussions. There were new council members this year
which included two SON graduates. This was especially significant as they had both
been matriculated in the BSN program and one of them a recent graduate of the MSN
program. There was also representation from current ADN, dual degree, BSN, and
MSN students who are invited to speak to the council to offer concerns, comments or
suggestions for the programs. An interview with my preceptor will follow week 3.
Weeks 2 and 3 and 4
Week 2 began with a panel of recent graduates for both our ADN and dual
degree programs. I was able to participate in facilitation of the discussion
surrounding the transition into professional nursing practice. The lively discussion
included current student concerns about preparing for the NCLEX and job seeking
prior to entry into professional practice. We also presented an activity this week for
discussion about delegation as it relates to supervision and discharge planning.
Leadership Role Interview
An interview with my preceptor as the SON pre-licensure assistant dean
revealed some behind the scenes critical components to our SON leadership
responsibilities. The External Advisory Council is a select group of healthcare
professionals and leaders who have a direct investment in our SON and the students.
They are invited to apply for the council and approval is determined by the SUNY
Delhi Provost. Each SON has an External Advisory Council to offer assistance or make
recommendations for what they are seeing as nursing trends and needs. The Advisory
Council keeps the SON apprised of what the healthcare needs are at their facilities
and makes recommendations for improvement or comments on successes.
Facilitation of this meeting for the SON requires foundational knowledge of the
requirements and substantial community connections, as well as the administrative
approval process. It is important to note the nurse leaders in our SON and in our
communities are positioned for their role whether as academic faculty or members of
institutional administration. The roles require each individual to be confident in
taking a risk in pursuing, accepting, and performing at a high level of decision making.
Assuring they have all the facts to make a personal decision which is best for them
and their livelihood. The role of a nurse leader also has the responsibility and the
ability to make decisions which may be unpopular, but best for the institution and its
members (Pearsall, Pardue, Horton-Deutsch, Young, Halstead, Nelson, & ... Zungolo,
2014).
APA Workshop Preparation
I also spent time preparing for the APA workshop. I have selected some
primary reference materials and made hand-outs for students to keep after the
workshop. There are select items related to referencing articles in-text and on a
reference list from my APA manual and notes (American Psychological Association,
2010). I have a few slides of examples of citations and reference lists to use and have
students work together to make the corrections. It is planned to be interactive and I
will provide additional remediation to students if requested.
Class Preparation and Planning
Planning class content activities for week 4 includes leadership, management,
and professional accountability for nurses. A visit from the BSN-MSN recruiter is
included in week 4 activities and I plan to speak to the students with her to encourage
this group of ADN students to pursue matriculation into the BSN program. We will
also have a session on preparing for and registering for the NCLEX exam.
Reflection
In the first week of class I have to admit was a bit overwhelmed with starting
out in week 1 teaching the NURS 265 class on my own. It was a good start to the class
as it involved group work preparing for the health fair projects. The students had
appropriate question and I was able to provide a comprehensive list of reliable
websites as resources. I attended several classes including a guest speaker on
horizontal violence to observe my preceptors approaches in the classroom. I felt
confident and well prepared to present a classroom topic I had planned for a class,
which surprised me a bit because I have never been comfortable in the spot-light. As
I eased into the topic of information technology, I knew I wanted the topic to support
an interactive flipped classroom, so I asked open questions from the reading which
invited a very comfortable exchange of ideas. From there, the electronic scenario
simulation (despite a computer update which did throw a curve into the presentation)
went very well. I felt like a teacher that day and anticipate that feeling to continue.
I am starting to believe I have gradually become more confident in front of the
classroom without realizing it.
I am especially grateful to have been given the opportunity to do the APA
evaluation for every student’s paper. It was a realistic look into the role of the
instructor for a class and the number of hours and dedication it takes to get through
each and every one. In order to provide effective feedback, the student needs to
understand what went wrong. My preceptor and I identified the students were not
well prepared for APA style writing and want to amend that the best we can for the
future. In the meantime, holding a workshop to provide access to resources and
foundational answers is a start. I am actually very excited about this.
Week 1 also included attending the SON External Advisory Council meeting with
my preceptor. In her role as Assistant Dean for the pre-licensure program of the SON,
she has a great responsibility in assuring our new graduates can meet employment
needs of our communities as safe and effective employees. By the end of week 1 I
was feeling drained. I have a full-time job and this week was wonderful, but
tiresome. I asked myself what I would do if I was teaching this course all the time,
would I be as effective as I felt this week, and is it always going to be this much work?
Then in weeks 2 and 3 there was more opportunity for co-teaching in the classroom
with a panel discussion with recent graduates. It was nice to have the recent grads
acknowledge me as an instructor for the class. I have prepped for and participated in
several classes now. Week 4 classes are nearly prepared and I am not sure how my
preceptor does it all as the Assistant Dean and class instruction and preparation.
My preceptor is new to her role as the Assistant Dean, so when I interviewed
her this week it made me realize how confidence and determination can help with
overcoming hurdles and providing effective leadership. I have prepped for presenting
the APA workshop, I have to say this feels more like an accomplishment than it does
work. I feel like I have discovered something and need to see it through to the end.
Keeping up with the workload has been a struggle as week 4 is upon us and I am
feeling overwhelmed with prepping for subsequent NURS 265 classes, my full time
job, and the demands of the NURS 605 practicum assignments. Yesterday, I thought I
would cave, today I am determined to conquer.
American Psychological Association (2010). Publication manual of the American
Psychological Association (6th ed.). Washington, DC: Author.
Cherry, B., & Jacob, S. R. (2014). Contemporary nursing, issues, trends, &
management (6th ed.). Mosby: St. Louis, MO.
Jefferies, D., McNally, S., Roberts, K., Wallace, A., Stunden, A., D'Souza, S., & Glew,
P. (2018). Review: The importance of academic literacy for undergraduate
nursing students and its relationship to future professional clinical practice: A
systematic review. Nurse Education Today, 60, 84-91.
doi:10.1016/j.nedt.2017.09.020
Oermann, M. H., & Gaberson, K. B. (2014). Evaluation and testing in nursing
education (4th ed.). Springer: New York, NY.
Pearsall, C., Pardue, K. T., Horton-Deutsch, S., Young, P. K., Halstead, J., Nelson, K.
A., & ... Zungolo, E. (2014). Becoming a nurse faculty leader: Doing your
homework to minimize risk taking. Journal of Professional Nursing, 30, 26-33.
doi:10.1016/j.profnurs.2012.10.010
STAR-NY (2018). About STAR-NY. Retrieved from http://www.starny.org/about