RUNNING HEAD: Final Teaching Project

Final Teaching Project

Raymonta Green

April 23, 2023

Kennesaw State University

WellStar School of Nursing

NURS 7723 – Instructional Methods & Outcome Measurements

Dr. Jane Brannan

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Abstract

Combat tourniquets are a vital piece of equipment for lifesaving in emergencies. These

tools are made to stop bleeding in the case of a violent injury, such as those that are frequently

experienced in battle circumstances. Tactical tourniquets have been demonstrated to be quite

successful in lowering fatality rates and enhancing recovery for injured people. Tourniquets are

simple to use and may be swiftly applied by professionals and those that are trained. In this

paper, the writer discusses the key points of focus and the preparation of preparing a small block

of instruction on training for the proper management and application of a tactical combat

tourniquet. The major objectives of the course included demonstrating the proper application of a

tourniquet in the appropriate body site as well as recognizing whether a tourniquet has been

applied efficiently. In preparing material for the class, different learning styles were considered

to provide a variety of learning materials that attracted each learner's preferred learning style.

The material was uploaded to an interactive learning website for access to students. Over the

course of two weeks, students were allotted time to review material and completed a

comprehensive quiz. The overall grade of 76.5% from the learners’ efforts on the exam fell

slightly below the benchmark of 80%, which indicates that there is still remediation on learning

that can be conducted and further testing again. However, the overall acceptance and eagerness

of learners to the material, indicates that the topic is engaging and something that can be carried

alongside future practices. The attitude that the learner should take away from the block of

instruction is the impact of decreasing mortality from hemorrhaging with early interventions

inside and outside of the hospital setting.

Keywords: combat, tourniquets, hemorrhage, learners, effective, life-threatening, and application

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Course Description

Training is intended to provide learners with the information and abilities needed to

correctly apply a tourniquet in an emergent hemorrhaging situation. Learners will gain the

fundamentals of applying a tourniquet, the justifications, limitations, as well as the proper

procedure for doing so. Learners will benefit from this course by increasing confidence and

knowledge to intervene in an emergent situation as well as reducing the risk of complications

associated with situations involving massive hemorrhaging.

Learning Environment

For this block of instruction, the intended group of learners that this is aimed towards are

members who are in the medical field with varying backgrounds in medical and nursing

education. This course is open and available to members along the spectrum of healthcare such

as nursing assistants, medical assistants, practical nurses, registered nurses, practitioners,

physician assistants, physicians, etc. To ensure that the classroom setting is intimate and

personalized for the best learning experience, the classroom will be limited to just twenty

learners at a time. The modality of this training will be conducted in a face-to-face mannequin

lab classroom, with aid from a projector, as well as a desk available for hands-on application and

assessments of tourniquet as well as theory for the tourniquet. This course will take place over a

four-hour block of time. In preparation for the course, learners registered for the class will be

sent a link where purchasing a CAT (Combat Application Tourniquet) is available to bring on

the day of class. This will allow learners to have personal tourniquets not only for use in the class

but for practical use in the future. Two days before the class start, learners will gain access to the

material (i.e., PowerPoint, handouts, videos, and checkoffs) to study and review and present to
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class with basic knowledge of the material and an opportunity for questions in class. The

instructor will also use this time to complete an introduction to the career and background in

nursing and the traits that make the instructor suitable to teach the course. Learners will be asked

to recall a time when an incident where hemorrhaging occurred and ask what the interventions

were if any and the outcome. This will serve as the icebreaker for the course and a focal point to

return to at the end of the course.

Student Learning Outcomes

Within this course, there are a few major outcomes that the learner will gain after the

block of instruction. To ensure the proper measurement and assessment of the learner with the

objectives of the course, each learner will receive a check-off sheet, that serves as a skill pop

quiz and will be responsible for ensuring that the instructor has a chance to initial beside each

skill needed. First, the learner will be able to identify life-threatening bleeding from non-life-

threatening bleeding and indication for placing a tourniquet. This is important for the learner to

grasp because every injury that is encountered will not result in the need for a tourniquet

placement. To evaluate this objective, learners will be broken down into groups of four with five

members each, paired with a mannequin. Learners will then be able to differentiate between

venous, arterial, and capillary bleeding, which ones require immediate intervention, and will

receive an initial check-off sheet if the objective is met satisfactorily. The next outcome is,

demonstrating the proper application of a tourniquet in the appropriate body site within one

minute. This is important for the learner to grasp because there are only a few sites on the human

body where a tourniquet can be placed, and the proper placement and application of those sites

need to ensure that bleeding is stopped. Within those same groups forementioned, each member
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will take turns identifying the correct sites where tourniquets may be applied and take turns

placing a tourniquet to get the feel of how much force is needed to stop hemorrhaging as well as

how it feels to have a tourniquet placed. Once completed, learners will receive an initial on the

check-off sheet if the objective is met satisfactorily. The last outcome of this course is to

recognize whether a tourniquet has been applied efficiently or not within fifteen seconds. This is

important for the learner to grasp because if a tourniquet is not applied correctly, then the

hemorrhaging will continue and as a result cause the patient to bleed out. Within those same

groups forementioned, each group will go to an assigned mannequin, and take turns immediately

identifying life-threatening bleeding, applying a tourniquet, and checking to ensure that the

tourniquets are effectively stopping the hemorrhaging. This does not serve as the final skill

check-off needed to complete the course. Once completed, learners will receive an initial on the

check-off sheet if the objective is met satisfactorily.

Course Content/ Time Allotment

The course time allotment will be a five-hour block. The class will begin promptly at

eight o’clock in the morning and will be completed by one o’clock in the afternoon. Learners are

expected to enter the class with the purchased CAT tourniquet, learning materials made available

online days prior, questions, as well as recollection of a situation that involved massive bleeding

(if applicable) for icebreaker activity. From eight o’clock until eight-fifty, the instructor and

students will take time for introductions, icebreakers, life experiences, objectives of the course,

layout of the classroom, and agenda of the day. There will be a ten-minute break from eight-fifty

until nine o’clock. Once students return at nine o’clock, the next block of instruction will be fifty

minutes ending at nine-fifty. During this time, the instructor will go into detail about the material
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given before class, starting with the short PowerPoint presentation about the tourniquet and

proper application, a YouTube video on the application of the tourniquet, as well as the pamphlet

with step-by-step instruction written out on how to apply the tourniquet. The learners will be

given a chance to ask any questions for clarification and given time to connect the dots with the

material presented. There will be a ten-minute break from nine-fifty until ten o’clock. Once

students return, check-off sheets for the skills pop quiz will be issued. Learners will be broken

down into groups of four with five members each and assigned to various mannequins in the

learning environment. From ten o’clock until ten-fifty, students will have a chance to practice

skills just learned and are instructed to notify the instructor when once ready to be checked off

for the practice skill outcomes aforementioned in “Learning Environment”. All students should

be checked off no later than by ten-fifty, allowing for a ten-minute break from ten-fifty until

eleven o’clock. Once the students return at eleven o’clock, all materials will be placed away in

preparation for the quiz. Students will have thirty minutes to complete the comprehensive ten-

question quiz on the material. Once each student completes the quiz, it will be graded in front of

the student, and a pass or fail will be issued to proceed with the practical examination of the

course. For learners that do not pass the quiz, remediation, and completion of the course and quiz

will be scheduled on another day of instruction. For learners that have passed the course,

instructions will be given to remaining in the hallway for practical application of the tourniquet.

Starting at eleven-forty-five, each student will enter the classroom one at a time to complete the

check for application. Learners will be presented with a mannequin that has not been seen during

the class and instructed to identify bleeding, apply a tourniquet, and check the efficiency of the

placed tourniquet. Students must complete the application of the tourniquet in under one minute

and must check the efficiency of the tourniquet in fifteen seconds. Once completed, a
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certification of completion and CEU hours will be awarded to students. The same pattern will

follow for all remaining students. For learners that do not pass the practical application portion,

remediation, and completion of the course, quiz, and practical application will be scheduled on

another day of instruction. Completion of the practical application should be completed by

twelve-forty-five. Once all students have completed the testing, all that have passed both

portions will return to the class for debriefing, learning objectives, and course evaluation.

Completion of instruction for the day will be done at one ‘o’clock.

Learning Theory

For this block of instruction, the writer believes that the learning theory most appropriate

for this would be experimental. The literature describes this type of learning as “experiencing

something and evaluating it” (Billings & Halstead, 2020, pg. 252). Experimental learning, which

includes practical applications and active engagement in the learning process, is a crucial

component of education. Because it enables students to apply what has been learned to actual

circumstances, this kind of teaching can be very helpful in solidifying students' comprehension

of the material. Students may acquire the critical thinking, problem-solving, and creativity

necessary for success in many disciplines by participating in experiential learning activities.

Additionally, exploratory learning can aid students in deepening comprehension and appreciation

of a subject. To have the feeling of the tourniquet and where the proper placement of it should

be, it is required to have hands-on experience. With this learning style, the instructor can create

an environment in which the learner can have first-hand experience. By doing this learning

theory, the learner will learn the risk of failure or success from an educational and safe practical

application before utilizing the skill in a hostile or emergent situation.

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Teaching Strategies

Understanding that no two learners are alike is important to the instructor’s success in the course

in ensuring that the objectives are being relayed effectively. For learning and information

acquisition to be successful, teaching tactics are essential. A student's capacity to comprehend

and remember the content can be significantly impacted by the way the information is presented

and delivered. Effective teaching techniques go beyond only imparting knowledge; they also

require involving students through a variety of techniques, including interactive exercises, group

discussions, and multimedia presentations. These techniques can support students' growth in

critical thinking, problem-solving, and subject-matter comprehension. The major strategy in play

that the instructor will use to ensure that everyone has a chance to learn the material, is by

attempting to accommodate each different learning style. For the auditory learner, there will be a

PowerPoint and literature review of the material that emphasizes the purpose, application, and

efficiency of a tourniquet and allow for questions at the end. For visual learners, there will be a

video provided of step-to-step instructions on how to apply the tourniquet as well as time for

open discussion on the material and allow for questions at the end. For learners that use read and

write, there will be a skill checklist provided with step-by-step instructions on how to apply the

tourniquet along with a case study of the importance of them. Lastly, for the kinesthetic learners,

there will be a physical tourniquet with a mannequin for manipulation and practice of the skills

and materials taught.

Assessment Strategies

Assessment of students is a crucial component of the educational system. Students get the chance

to show knowledge and comprehension of the subject learned by taking tests. Assessments also
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enable instructors to evaluate the efficiency of instructional strategies and modify strategies as

needed. Tests can motivate learners to study and learn by pointing out areas needed to improve.

The learner will be measured with a 10-question quiz that consists of mixed questions with fill-

in-the-blank, multiple choice, and matching. A score of 80 % or more must be obtained for the

learner to progress on to the practical skill application portion, in which an 80% or more must be

obtained to successfully pass the class and earn the certificate. A written examination, as well as

a practical examination, was chosen because the course is theoretical and practical. To complete

the course, there is basic knowledge of human anatomy and physiology needed for this block of

instruction as well as practical hands-on components. For learners that do not pass the quiz or

practical portion of the course, remediation, and completion of the course, quiz, and practical

portion will be scheduled on another day of instruction.

Alignment

To guarantee that learners are receiving a thorough and coherent education, alignment in

education is essential. Aligning the curriculum, education, and evaluation is necessary to make

sure that both learner and instructor are working toward the same objectives. Learners are better

able to comprehend the objective of learning and how it relates to future goals when there is

alignment. Educators may concentrate on the most crucial ideas and abilities, which is more

effective in education and evaluation. The purpose of the block of instruction is to illustrate the

importance of a tourniquet and the part it plays in an emergency that involves massive

hemorrhaging. The objectives of the course align with the purpose of the block of instruction by

focusing on (1) identifying life-threatening bleeding from non-life-threatening bleeding and

indication for placing a tourniquet, (2) demonstrating the proper application of a tourniquet in the
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appropriate body site within one minute, and (3) recognizing whether a tourniquet has been

applied efficiently or not within fifteen seconds. The teaching strategies align with both the

purpose and objectives by allowing multiple avenues to receive instruction through (1) creating

PowerPoint and literature reviews of the material that emphasizes the purpose, application, and

efficiency of a tourniquet, (2) creating a video provided of step-to-step instructions of how to

apply the tourniquet as well as time for open discussion, (3) creating a skill checklist provided

with step-by-step instructions of how to apply the tourniquet along with a case study, and (4)

providing a physical tourniquet with a mannequin for manipulation and practice of the skills.

Assessment aligns with the other elements of the course by assessing with a written exam that

focuses on the theory and usage of the tourniquet and the practical examination which focuses on

the practical component of application of the tourniquet. The course and its elements align and

indicate that both learner and instructor are working toward the same objectives

Summary

In a journal focused on the development of a self-tightening tourniquet, it was noted that

“Uncontrolled hemorrhage remains a leading cause of death in both emergency and military

medicine. Tourniquets are essential to stopping hemorrhage in these scenarios, but they suffer

from subjective, inconsistent application” (Vega, et., al, 2022). The writer has

served in the military during several combat deployments and values the importance firsthand of

properly installing a tourniquet and how it correlates to a higher survival rate after a traumatic

event. The purpose of this block of instruction is to educate on how to properly apply a

tourniquet in an emergent situation where hemorrhaging is the priority.

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References:

Billings, D. M. G., & Halstead, J. A. (2020). Teaching In Nursing: A Guide for Faculty

(6th ed.). Elsevier.

Vega, S. J., Hernandez-Torres, S. I., Berard, D., Boice, E. N., & Snider, E. J. (2022).

Development and Characterization of a Self-Tightening Tourniquet System.

Switzerland), 22 (3), 1122. https://doi.org/10.3390/s22031122

Appendix: