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fl uid and electrolyte balance, ambulation, mobility, pain management, and risk reduc- tion of falls and pressure ulcers, is primary.
The reinforcement of the general care of a patient allows the learner to apply the con- cepts in a specifi c situational context. The learners will also be able to identify con- cepts that could manifest in other patient populations (Nielsen, 2009). As an example, how would the care of the aforementioned patient differ if this patient would present as an 85-year-old? The concept of geriatric care must also be integrated as an adjust- ment in the nursing care plan (Nielsen, 2009). Lastly, the introduction of the chal- lenges of the health care delivery system mandates reportable events such as Stage III pressure ulcer, and readmission in 30 days can be introduced. Refl ection on these entire variables of care becomes an integral component of concept-based curriculum (Engelmann, 2010; Lasater & Nielsen, 2009;
Nielsen, 2009).
SYNOPSIS
The call for innovation in nursing education and the enhancement of professional nurse performance to the highest level of training have recently been addressed in the Carnegie Report and Institute of Medicine Report on the future of nursing (2010). The literature is replete with articles on concept-based learn- ing in the academic setting. However, the application of this approach to the education of professional nurses is critical to continued professional development.
Concept-based learning outcomes identi- fi ed in the literature include improved critical thinking; problem-solving skills; integration and synthesis of knowledge (Heims & Boyd, 1990; Lasater & Nielsen, 2009; Nielsen, 2009);
self-direction; information retrieval; and motivation (Nielsen, 2009). Identifi cation of learning needs (Heims & Boyd, 1990);
team work; learning from peers and group process (Nielsen, 2009); creative discussion (Nielsen, 2009); connecting theory into prac- tice (Lasater & Nielsen, 2009; Nielsen, 2009);
and progression into the novice to expert delivery system, accessibility of informa-
tion through Internet technology, and exponential growth of the body of knowl- edge. Furthermore, due to the advances in nursing through evidence-based practice and data-driven outcomes, nursing educa- tors are faced with challenges to deliver an active learning environment. There is a need for teaching strategies that require rethinking pedagogical techniques and adopting innovative technologies in the nursing education infrastructure.
Simultaneously, there is an escalating need to address and bridge the theory-to-prac- tice gap in nursing (Bristol, 2014; Crookes et al., 2013; Engelmann, 2010).
Case studies, simulation, and nursing grand rounds are some methods to inte- grate concept-based learning in a nursing education setting. For example, a case study is presented about a patient admitted to the hospital with multiple comorbid conditions.
K. W. is a 46-year-old obese female who has a history of type 2 diabetes mellitus. Her con- dition was complicated by coronary artery disease, for which she had a coronary artery bypass graft. Postoperatively, she developed acute renal failure and Stage III pressure ulcer. Her hospital stay was complex, requir- ing a full integration of knowledge and skills of nursing care. After discharge at home, due to her noncompliance with medications, she also developed congestive heart failure. K. W.
was readmitted within 30 days. Application of a distinct knowledge base alone would not prepare the nurse for this patient’s plan of care. The interplay of multiple concepts serves as a superior teaching methodology as compared to an isolated didactic knowledge or practice of skills.
The learners will follow this patient during the course of hospitalization and discharge to home, followed by subsequent admissions and discharge to a subacute set- ting. Learners apply the nursing process through identifying pertinent assessment fi ndings, making a nursing diagnosis, plan- ning and implementing interventions, and evaluating outcomes. The integration of basic concepts, such as oxygenation, nutrition,
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Bristol, T. (2014). Flipping the classroom.
Teaching and Learning in Nursing, 9, 43–46.
Crookes, K., Crookes, P. A., & Walsh, K. (2013).
Meaningful and engaging teaching tech- niques for student nurses: A literature review. Nurse Education in Practice, 13(4), 239–243.
Dewey, J. (1916). Democracy and education: An introduction to the philosophy of education.
New York: The Free Press.
Engelmann, L. (2010). Clinical learning: Do faculty teach how to learn? Teaching and Learning in Nursing, 5, 93–94.
Facione, P. A. (1990). Critical thinking: A state- ment of expert consensus for purposes of educational assessment and instruction.
Retrieved from http://fi les.eric.ed.gov/
fulltext/ED315423.pdf
Heims, M. L., & Boyd, S. T. (1990). Concept- based learning activities in clinical nurs- ing education. Journal of Nursing Education, 29(6), 249–254.
Institute of Medicine. (2010). The future of nursing: Leading change, advancing health.
Retrieved from http://www.iom.edu/~/
media/Files/Report%20Files/2010/The- Fut ure-of-Nursi ng/Fut ure%20of%20 Nursing%202010%20Recommendations .pdf
Lasater, K., & Nielsen, A. (2009). The infl u- ence of concept-based learning activities on students’ clinical judgment develop- ment. Journal of Nursing Education, 48(8), 441–446.
Merriam-Webster Online Dictionary. (2014).
Retrieved from http://www.merriam- webster.com/dictionary/concept
Nielsen, A. (2009). Concept-based learning activities using the clinical judgment model as a foundation for clinical learn- ing. Journal of Nursing Education, 48(6), 350–354.
Vacek, J. (2009). Using a conceptual approach with concept mapping to promote criti- cal thinking. Educational Innovations 48(1), 45–48.
Maria L. Vezina Medel Salvador-Paguirigan continuum (Benner, 1984; Benner, Sutphen,
Leonard, & Day, 2010; Nielsen, 2009) are also demonstrated with this style of teaching/
learning.
RECOMMENDATIONS
Despite the limited literature available to apply concept-based learning, this has sev- eral benefi ts and implications for nursing education. Adjusting the way students learn translates into enhanced performance in clini- cal practice within the complex environment of health care in the 21st century. A balanced approach between active and passive learning to introduce new information and reinforce best practices is critical to safe, effective, and effi cient health care delivery. More research is needed to evaluate concept-based curricu- lum using a measure of learning outcomes, such as the Lasater Clinical Judgment Rubric (Adamson, Gubrud, Sideras, & Lasater, 2012).
Finally, shared outcomes, as a measure of success, will promote faculty to be creative in developing innovative teaching strategies to provide a learning environment that pro- motes critical thinking and clinical decision making in a nonthreatening environment (Engelmann, 2010). A concept-based learning curriculum provides a venue to build knowl- edge, skills, and competence through analysis and synthesis rather than recall of isolated facts. Furthermore, a concept-based curricu- lum builds educational experiences that strive to prepare the nursing workforce to deliver high-quality care for patients and families.
Adamson, K. A., Gubrud, P., Sideras, S., &
Lasater, K. (2012). Assessing the reliability, validity, and use of the Lasater Clinical Judgment Rubric: Three approaches.
Journal of Nursing Education, 51(2), 66–73.
Benner, P. E. (1984). From novice to expert:
Excellence and power in clinical nursing prac- tice. Menlo Park, CA: Addison-Wesley Pub. Co., Nursing Division.
Benner, P., Sutphen, M., Leonard, V., & Day, L. (2010). Educating nurses: A call for radical transformation. San Francisco, CA: Jossey- Bass.
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fi nd it more meaningful to defi ne relation- ships between data by using a concept map (Hicks-Moore, 2005).
Concept mapping may allow for a bet- ter understanding and memorization of complex phenomena, thus promoting active involvement of the student in the learning process (Billings & Halstead, 2012). It is par- ticularly useful for courses with a high level of theoretical content because it can pro- vide insights into the relationship between theories and concepts (Angelo & Cross, 1993). This method of learning assists fac- ulty in clarifying students’ misconceptions about relationships and concepts (Billings &
Halstead, 2012). Concept mapping can be a useful teaching/learning strategy for most types of learning styles; however, it may not appeal to concrete or auditory learn- ers. This approach is time intensive for both students and faculty (Billings & Halstead, 2012). Concept mapping may be enhanced through software available on the Internet.
Although it may take time to become famil- iar with the software and technique, it can be a useful tool.
A concept map is best used for forma- tive evaluation. Furthermore, it can evalu- ate in a written paper in which a concept is illustrated with a map (Oerman & Gaberson, 2014). A grading rubric for a concept map is helpful for students, particularly if they are new to this method of learning. The concept map can be graded based on com- prehensiveness of the data, correct linkages and justifi cations, and a developed plan that is specifi c, relevant, and accurate (Oerman
& Gaberson, 2014). Evaluation criteria can also include number of items included, clar- ity of overarching organizational structure, and categorization of concepts (Billings &
Halstead, 2012).
SYNOPSIS
The utilization of concept maps in the clini- cal setting, in lieu of traditional care plans, is a helpful tool to facilitate data gathering, critical thinking, and carrying out a plan of