Applied Practice Teaching Report

Jacqueline Butsavage

NUR 630

Pennsylvania College of Health Sciences

 Teaching Project Summary

The purpose of this teaching project is to explain the unique characteristics and types of

cerebrovascular accidents (CVAs). Due to the COVID-19 pandemic and current circumstances,

changes had to be made and temporarily assigned a new preceptor to work with, Kathy

Leonardo. Kathy is an educator at the PA College of Health Sciences teaching final semester

Baccalaureate nursing students. Together, we discussed the topic of CVAs and reviewed the

required elements to be incorporated in the presentation. The class title is Nursing 405, which is

Health and Illness IV. Nursing and educating nursing students are the forefront of teaching

recognizable, relevant, and acceptable methods of education. CVA is a component of the

Nursing 405 curriculum. CVA is a commonly occurring health issue that can affect anyone at

any age. The course is health and illness, which provides students the opportunity to broaden

their knowledge of regulatory mechanisms and psychological alterations. The students learn

different health conditions and illness managements. Students can synthesize their learned

knowledge, skills, and concepts into being able to care for patients with health issues such as

CVA and other types of complex health conditions. The relevance of educating students on

CVAs is a noteworthy part of health and illness. Nursing students need to be cognizant of CVA

prevention and also the essential treatment. Under normal circumstances, the topic of CVAs is

taught during a lecture in a classroom, allowing for a discussion time to evaluate that the students

are understanding and or if the students potentially have any questions. Unfortunately, due to

social distancing, a classroom lecture was not permissible. Through discussing with my

preceptor Kathy Leonardo, the method of presentation on CVAs was determined to present

through a PowerPoint with voice over. This type of technique of teaching is both innovative for

current nursing students and also for future presentation of teaching. This type of approach to
teaching is beneficial but it can also be challenging. A benefit is specifically discussing a health

problem and present the information allowing the student to view that information when a

specific topic is being learned. The prerecorded method of teaching is one directional, in which

it has limitations, and does not allow the educator to interact with the students or be able to

directly assess if the students are interested or engaged with the information being taught. The

student can also be confronted with challenges, by not being able to discuss the information

about CVAs or if the student has any questions or the students may have already learned the

information being taught and the educator is not cognizant of their current academic background.

The strengths I bring are to the teaching this topic on CVAs is currently working as a nurse in a

Neuro Science Intensive Care Unit (NSICU), I have been working in NSICU for 10 years, and

caring for CVA patients. Continuing my lifelong journey of learning, returning back to school

attaining my Master’s Degree in education. Through the courses I have taken, I have gained and

strengthened my knowledge in research, curriculum development and design, educational

assessment, pharmacology, and pathophysiology, in which educationally and experientially

qualifies that I can comprehensively teach multiple topics. The only limitation in teaching the

topic of CVAs is being concise and keeping the video presentation within a one-hour time frame.

Unfortunately, due to the time frame restriction of the video being one hour long there was not

enough time to elaborate on my personal experience or direct discussion about specifically

caring for certain types of CVA patients. The hope is that this teaching project on CVAs will

enhance the student’s knowledge. Nursing student have a tremendous amount of information to

learn and cover, developing a basic understanding of CVAs, the plan of CVA treatment, the

capacity to identify early signs of CVA prevention, and in return can lead to assisting in optimal

patient care and outcomes.

 Teaching Blueprint
Topic: _Cerebrovascular Accident (CVA)_____4/15/2020_______________ Time Allotment: __1 hour_______

Objectives Teaching Method(s) Evaluation Plan

Discuss what a Cerebrovascular Accidents (CVA)
is and the type of CVAs.
1. Identify the unique characteristics of the types of
CVA.
2. Explain the nursing assessment for a patient
experiencing a CVA.
3. Describe modifiable and non-modifiable stroke
risk factors.
4. Explain the typical diagnostic testing and
treatment modalities of CVA.
5. Discuss assessment findings to the underlying
pathology of the affected area of a CVA.
6. List the medical management that are commonly
used to treat a CVA.
7. Explain nursing diagnosis and interventions
related to CVA.
The student can analyze the resources from the
teaching plan contained in the curriculum and
according to the organization’s mission and
philosophy.
Power Point Presentation with voice over was
presented to student nurses in Mrs. Kathy
Leonardo’s class of NUR 405 Health and
Illness IV which was an appropriate method.
Provide the Power Point presentation for the
students to follow and be able to take notes.
Develop two case studies and ask specific
questions for the students to answer about
each of the case studies.
Course Outcomes of the student:
1. Identify the of types of CVAs and causes
2. Integrate nursing assessment of CVA
patients
3. Synthesize the nursing interventions and
plan of care to treat CVA patients
Learner Evaluation:
Provide the students with five pre and five
post-tests questions having multiple choice
answers.
Assess the students understanding and applied
knowledge learned from the CVA Power
Point presentation and the responses to the
questions.
Self-Evaluation:
Statistically analyze and evaluation of the data
from the responses of this performance. I reviewed
the students completed post presentation
responses. The student’s responses all agree to
achieving the learning objectives and align with
the mission and philosophy of the college in this
teaching project of the continuous acquisition of
knowledge. Evaluation of both quantitative and
qualitative measure is discussed. Self-evaluation
strengths and weakness is expressed.

Connection to PA College’s mission and philosophy

The main focus is to sustain the educational goals as a community, PA College of Health Sciences builds and supports the

community by offering a variety of educational programs, promoting ongoing intellectual growth and character development by
promoting value and commitment to the community. The PA College of Health Sciences institutional mission is to educate for

excellence in health care, leadership, and continuous acquisition of knowledge. The core philosophy of PA College, faculty, and staff

is that the institution is at the center of our students’ learning universe. Every student is unique, individual, adaptable, possessing

intrinsic worth. Philosophy values are integrity and self-motivation for intellectual growth and character development. The student

evolves within society, through the shaping and exposure of the culture and heredity. Society consists of individuals, family, groups

and the community that are dynamic and global coexisting together by developed history, language, and thoughts. Learning happens

when interactions occur, opening the possibility and opportunity actuation of knowledge. A nurturing learning environment promotes

refinement of different self-awareness, perspectives, and advancement of scholarly social consciousness. This teaching project and

blueprint aligned with the college’s mission and philosophy with continuous acquisition of new skills, attitude, learning. and

knowledge.
 Budget Submission

The budget for the Cerebrovascular Accident (CVA) Presentation was a one-hour Power

Point presentation with voice over was used as a teaching method. Students were provided with

a copy of the CVA presentation to follow the presentation and to be able to follow and take notes

on the presentation.

Instructor Salary:

Prep time: 12.5 hours x 56.60/hr. = $707.50

Presentation time: 6 hours X 56.60/hr. = $339.60

Evaluation: 1-hour x 56.60/hr. = $56.60

Simulation instructor: 1-hour x 56.60/hr. = $56.60

Instructor Salary Total………………………. $1103.70

Educational Supplies and Facilities: Student laboratory supplies needed are $4.50 times the
number of students in the session and additional simulation expenses are $31.00/hour per student
in the class and can also have virtual simulation class that can cost $100 per student. There were
approximately 20 students were in Mrs. Kathy Leonardo’s NUR 405 class, the cost would be
$2710.00 for a laboratory and simulation class on CVA. This was an online educational class.
There were no additional educational supplies needed, students provided the power point
presentation slides to be able to view and download to follow, listen to, view the presentation,
and take notes on cerebrovascular accidents. Total expense of this 1-hour lecture potential
laboratory and simulation costs can be: $3813.70.
Reflection: I have a new found appreciation for educators. I now have a better understanding of
behind the scenes work and commitment that an educator has when preparing, presenting, and
evaluating teaching a class. There is a lot of work time and effort that is put into teaching,
identifying the dollar value of cost also really puts educating into perspective. I did not only
consider lecture time, but I also thought about laboratory and simulation fees that nursing
students have to complete, taking into consideration the educational supplies, and facilities
needed. The total budget cost was more than want was anticipated to cost.
 Teaching Project Presentation
https://youtu.be/0bswem5AcDs

Pre-CVA presentation test questions:

1. A patient is exhibiting stroke like symptoms. Paramedics arrive on the scene and start to ask
the patient the acronym F.A.S.T. What does the S. in the acronym stand for?

a. Smile
b. Symmetry
c. Speech
d. Sensation

2. There are primarily two types of cerebrovascular accidents (CVAs). What are the two types of
CVAs?

a. infarct or hematoma
b. ischemic or hemorrhagic
c. intrathecal or hematochezia
d. idiopathic or hypothalamic

3. A patient is having left sided hemiplegia with their hand, arm, leg, and foot. In general, after
assessing the patient what area of the brain would be effect on their Cat Scan results or what type
of stroke is the patient experiencing?

a. left hemisphere stroke

b. suboccipital stroke
c. right hemisphere stroke
d. left lacunar stroke
4. What is considered a modifiable risk factor for stroke?

a. age
b. hypertension
c. race
d. genetics

5. What is a sudden loss of neurological function caused by an interruption of blood flow to the
brain called?

a. seizure
b. myocardial infarction
c. cerebrovascular accident
d. spinal stenosis

Post-CVA presentation test questions:

1. A patient called 911 and is complaining of the “worse headache of his life” also known as a
thunderclap headache. What type of stroke is the patient experiencing?

a. hemorrhagic
b. ischemic
c. cryptogenic
d. cardiogenic

2. A patient is admitted with uncontrolled atrial fibrillation. The patient’s medication includes
Coumadin, Multivitamin and Metoprolol. What type of stroke is the patient MOST at risk for?
a. hemorrhagic stenosis
b. ischemic hemianopia
c. ischemic embolic stroke
d. hemorrhagic hemisphere

3. A patient is experiencing stroke like symptoms left sided weakness, hearing problems and also
had seizure activity. What lobe in the brain would be expected to be expecting their stroke is
affecting?

a. frontal
b. temporal.
c. parietal
d. occipital

4. Which patient listed is at most risk for having a hemorrhagic stroke?

a. A 27-year-old athletic female that has bradycardia

b. A 83-year-old male with spinal stenosis
c. A 60-year-old male with uncontrolled hypertension
d. A 46-year-old female with cardiac arrthymia

5. A patient is experiencing a stroke like symptoms. The patient had a STAT CT Scan on arrival
to the emergency department, which revealed that the patient is having an ischemic stroke. The
Neurologist on call performs a National Institute Health Stroke Scale (NIHSS). The patient ‘s
NIHSS score is a 38, according to the scale what are the results of the patient’s stroke
symptoms?
a. no stroke symptoms
b. severe stroke symptoms
c. mild stroke symptoms
d. moderate stroke symptoms
Case Study 1:

76-year-old female at 9:30am begins to experience left hand, arm, leg, and foot weakness and
numbness. She also noticed having left sided visual changes. 911 was called and the patient was
taken to the emergency department, at 11:00am the paramedic notified the hospital of the
patient’s arrival. Upon initial examination the patient is noted to have the following findings:
alert oriented times 4, her speech was clear, appropriate, and spontaneous, pupils 3 mm brisk,
equal, and reactive, left facial drooping, tongue midline, left sided hemiplegia and left sided
decrease in sensation, she is able to follow commands with right side. Vital signs: blood pressure
162/86, pulse 84 beats per minute and irregular, resp rate 18, and O2 Sat is 96% on room air.

1. What are some another potential reason that a patient could be exhibiting these symptoms?

2. The patient immediately goes for a CT Scan, what type of stroke is the patient most likely
experiencing?

3. The emergency MD identifies that the patient does meet the requirement for the only FDA
approved IV medication to treat this type of stroke, the maximum dose-weight based medication
is of 90 mg, and to administer 10% of the bolus dose bolus over 1 minute and the remaining 90%
over 1 hour, follow with a IV NSS flush to ensure the patient receives the full dose. What is the
name of that medication?

4.What is the “Gold Standard” diagnostic test to be performed for this type of patient?

5. If the patient does not meet the criteria for thrombolytic medication, what other options are
available for this patient?
Case Study 2:

72-year-old male collapses at home while eating dinner with his wife. 911 was called and the
patient was taken to the emergency department. Upon initial assessment the patient is noted to
have the following findings, arouses to speech, pupils 3 mm brisk, equal, and reactive, garbled
speech, tongue midline, right sided hemiplegia, he is able to briskly follow commands with left
side, and able to nod his head yes and no to questions asked. Vitals: blood pressure 186/92, pulse
88 beats per minute and irregular, resp rate 16, and O2 Sat is 94% on room air.

1. What type of stroke is the patient experiencing?

2. What are some causes that the patient would be predisposed to having this happen (modifiable
or nonmodifiable)?

3. Over next 48 hours the patient condition and neurological status deteriorates. He has a follow
CT Scan and shows that he has developed cerebral edema. What is the medication that the MD
will start the patient on?

4. What are some common medication that the MD will order to be started for this type of
patient?

5. If the patient is having aphasia and dysphagia, what are some of the precautions that the nurse
should maintain while caring for this patient?
Student Evaluation of the Cerebrovascular Accident Presentation
Strongly Disagree Neither Disagree Agree
Strongly

Disagree Nor Agree

Agree

The objectives of the presentation

were met 15 1 9

Was there new knowledge gained

from the presentation 16 8

The content of the presentation was

timely and relevant to the student 3 14 7

The presentation was well-organized

and appropriate for student 4 7 6 7

The information presented will be

beneficial in the student’s professional life 16 8

The time of the presentation and the

amount of material covered was appropriate 4 8 6 6

Any comments from the student about the presentation?

Disagree comments are too in depth for this class, but information was very informative, spoke a
little fast but appreciated kept less than an hour, need to talk slower, used advanced terminology
needed simpler explanation to understand the terms, add more slides but would make
presentation longer

Agree and strongly agree comments are thorough, very detailed, and explained well, great
presentation, great visual and visually appealing, enjoyed power point presentation, well
organized and made sense, well done.
 Teaching Project Evaluation
Kathy Leonardo was my preceptor for the CVA teaching presentation. Kathy notified me

that the qualitative and quantitative analysis of the students’ responses to the teaching

presentation. The students did very well on their exam on CVAs and their final exam.  She

incorporated the case studies I developed as a grade, in which the case study helped the students

to apply the concepts and promote critical thinking. She used my pre-test questions as a self-

assessment for the students to use prior to taking their exam. She utilized my post assessment

questions that I developed on the final exam. Feedback from Kathy Leonardo on my CVA

teaching presentation was I did an overall great job. She mentioned that it was evident that I put

a lot of work into the presentation and prep work. She noted that all the prep work was relevant

and helped prepare the students for the final.  She commented that the PowerPoint was good,

visually appealing and was well organized.  The presentation itself had more details in some

areas than students at this level need, the pathophysiology was advanced for them, and the

assessment was detailed. She did state that there was no way that I could have really known that

since I didn’t have the opportunity to really get to know the students or the exact course content

but only what I provided with knowing.  She also thought that, I was definitely at a disadvantage

with the amount of time I had to prepare. Overall, she thought that I did an excellent job. She

mentioned that it is obvious I am knowledgeable about the subject and had a lot to offer the

students.  She noted that there is never too much information to teach students, it never hurts

students, and for the over achievers it will push them to a higher level.  

An analysis of the students that commented on the CVA Presentation. Overall, the

student’s evaluations from the responses completed on the presentation was positive. 100% of

the students met the objectives of the CVA presentation. 100% of the students gained new

knowledge from the CVA presentation. 100% of the information presented is beneficial in the
student’s professional life. The three questions that yielded the agree and strongly agree are the

meeting the learning objectives, new gained knowledge learned, and information presented is

beneficial in the student’s professional life. The two mixed review on the evaluation questions is

the presentation was appropriate for the student and the amount of material covered was

appropriate. The majority of the students thought the presentation was timely and relevant, a

student commented too much information being too in detail. The agree and strongly agree

example of the common themes of the CVA Presentation was thorough, organized, well detailed,

and well explained. The CVA presentation and voice over is easy to follow, enjoyed the

presentation, and it is visually appealing. The disagree example of the common themes are

needed to talk slower, at times spoke a little fast but appreciated kept less than an hour. A few

additional comments made by student on their evaluations too in depth, but information in the

presentation was very informative, some of the information in presentation is too in detailed with

pathophysiology for this class, used advanced terminology needed to speak in simpler terms to

understand and recommend adding more slides but that would make presentation longer.

Overall, after reviewing all the evaluations the teaching presentation was successful.

Final Project Self Reflection

The final project is bittersweet and rewarding, towards finishing up the final course of

my Master’s degree. This final project is an eye-opening experience to what some of the

processes are to be an educator. After completing this teaching project, I really have learned and

gained true respect of educators and educating. The strengths I have are sharing all the

knowledge I have gained over the years of being a nurse. The weakness I have is the familiarity

of presenting a multitude of educational topic. I appreciate all the feedback from both the

preceptor and student nurses. There is always strengths and weakness that can be learned from
teaching and educating. There is a lot of information I have learned, and with all of this

understanding I now can incorporate it to educating. I have learned new skills in how to apply

and utilize different strategies in developing a lecture and topic content, by also maintaining the

focus in connection to the institutional mission and philosophy goals. Reflecting on the course

requirements has helped me understand that there is a lot of behind the scenes work that an

educator does in order to be able to adequately instruct students and to strive to improve the

future of education. I have a better understanding after completing this final project and I have

truly gained and developed a new enthusiasm about informed decision making that can effect

and to improve student learning.

My final self-reflection after completing the presentation is my proudest accomplishment

was being able to educate students on a topic that have a passion to teach about. A strength of

the presentation was that I was comfortable redesigning a Power Point presentation. The

weaknesses I know that I exhibit is lacking the experience of presenting and I know that I will

gain self-assurance as I pursue my educational aspirations. After completing this project, I

gained the understanding and knowledge of collaborating with an academic educator assisting in

instead of lecturing to making an alternative presentation in a class. A change I would like to

improve on is building confidence in speaking. A change in the future if I were to present this

topic again would be knowing the knowledge level of the nursing students that I would be

presenting to so that I can critique the proper terminology so that they would be able to

understand. I recognize that as I pursue teaching and educating, I will develop assurance with

being an educator.