Nurse Educator Vol. 38, No. 6, pp. 237-238 Copyright * 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Nurse Educator
Teaching Strategies
Creating a New View of Aging Mary C. DiBartolo, PhD, RN-BC, CNE Lisa A. Seldomridge, PhD, RN
Mary C. DiBartolo
Lisa A. Seldomridge
T
he older adult population represents a core segment of healthcare, yet few nurses are adequately prepared to tend to their unique needs.1,2 Presently, people older than 65 years comprise 12% of the population, with those numbers expected to double by 2030.3 As older adults live longer and with a variety of chronic illnesses, they will continue to use healthcare services, comprising more than 50% of all hospital days, 60% of primary care visits, and 70% of home care visits.4 These healthcare trends place an unprecedented demand for nurses to provide optimal care to this complex population.1,5,6 As a result, nursing programs are challenged to include evidence-based content and experiences to produce nursing professionals who provide ageappropriate, culturally competent care to meet the multifaceted needs of the aging community.7-11 After attending a Geriatric Nursing Education Consortium (GNEC), faculty at our mid-Atlantic university undertook ‘‘gerontologizing’’ their curriculum. The authors describe several assignments developed for the first adult health course in the baccalaureate nursing program blending theoretical and experiential learning to increase students’ knowledge, skills, and sensitivity in caring for older adults.
Description of Assignments Students begin the nursing curriculum with 3 credits each for adult health theory and clinical. Learning in the theory course is applied in the corresponding clinical course. In the first week of class, concepts related to caring for older adults are introduced using materials from the GNEC Web site. Topics include statistics supporting the geriatric imperative; myths and stereotypes associated with aging; biologic, sociologic, and psychological changes of aging; geriatric syndromes; and the American Association of Colleges of Nursing Gerontology Core Competencies.11 This discussion sets the stage for
Authors Affiliations: Professor (Drs DiBartolo and Seldomridge), Department of Nursing, Salisbury University, Maryland. The authors declare no conflicts of interest. Correspondence: Dr DiBartolo, Department of Nursing, Salisbury University, 1101 Camden Ave, Salisbury, MD 21801 (mcdibartolo@ salisbury.edu). DOI: 10.1097/01.NNE.0000435262.07871.70
Nurse Educator
upcoming experiential learning. In week 2, as part of the clinical course, students engage in a 2-hour Aging Sensitivity Simulation and Training for a first-hand experience with common changes of aging. Designed by RNs from the Eastern Shore Area Health Education Consortium, the simulation is used in a variety of settings to help caregivers gain awareness and compassion regarding caring for older adults. By donning glasses that mimic visual disturbances (presbyopia, cataracts, and macular degeneration), students begin to appreciate how routine activities are affected and might require modification. Wearing gloves with cotton balls in the fingertips (simulated arthritis), students must dress themselves in a button-up shirt, dial a telephone, open a child-proof medication bottle, and count out candy ‘‘pills’’ to fill a weekly medication dispenser. After rotating through 10 stations, students are debriefed with a focus on how they felt during the experience, what activities were the most difficult, what helped or hindered accomplishing each activity (A. Wahl, MSW, oral communication, September 2012). Participation in this experience was counted as part of a clinical day. In weeks 3 and 4 of the theory course, students embark on a GeroWeb scavenger hunt. Composed of 4 components, this activity introduces students to Web-based resources that could be helpful in working with older adults and their families and assists students in critical analysis of those Web sites. For component 1, students located a Web site of a nonprofit organization that provided information on a health condition commonly associated with older adults that was also being discussed in the adult health theory course. Examples included the American Heart Association, Arthritis Foundation, and Alzheimer’s Association. Students wrote 1 paragraph describing the kind of information available on the site and 1 paragraph on how the information could be useful to older adults and their families. Next, students were directed to a Web site with criteria for evaluating the quality of Web-based materials based on accuracy, authority, objectivity, currency, and coverage12 and were to apply these to the nonprofit organization Web site. For the second component, students were given a list of peer-reviewed nursing journals with a geriatric focus and directed to find a recently published article on an illness/condition associated with older adults. Students then wrote a brief summary of Volume 38 & Number 6 & November/December 2013
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
237
key points covered in the article and how the article would be useful to their nursing practice. The third component required navigation to the National Institute on Aging13 Web site to browse the ‘‘Age Pages’’ for a topic of interest. Students summarized the ‘‘Age Page’’ and discussed how the information would be useful for older adults and their families. The fourth component involved visiting the Hartford Foundation sponsored Web site (www .ConsultGeriRN.org) and exploring the section ‘‘Try This: Best Practices in Nursing Care to Older Adults,’’ where students could access 26 different assessment instruments/topics focusing on various geriatric issues such as Fulmer Spices Overall Assessment of Older Adults, Geriatric Depression Scale, or Fall Risk Assessment. After identifying an assessment instrument of interest, students wrote a brief description and discussed how they might use it in caring for an older adult. At the ‘‘Try This’’ Web site, students also had the option of watching a video clip demonstration of a nurse administering the instrument with an older adult client. Students submitted all 4 components at 1 time, and the project counted 10% toward their theory course grade. However, each component could be submitted separately with discussion of what students found during clinical conferences. During weeks 5 and 6 of the clinical course, students visited a community-based senior center and interviewed 1 of the participants. The initial encounter focused on establishing a professional relationship and using interviewing skills to take a medication and/or nutrition history. After analysis and discussion with faculty, students developed a teaching plan using resources gathered through the GeroWeb scavenger hunt. Upon return to the senior center 1 week later, students met their older adult client and provided education on identified knowledge deficits related to medications and/or nutrition.
Conclusion Research has shown that nursing students who experience ‘‘enriched’’ environments for learning, where they are exposed to evidence-based geriatric care standards and appropriate attitudes toward the aging population, are far more likely to view care of older adults in a favorable light.7 Although these activities focused on community-dwelling healthy older adults, they could easily be adapted to other settings. Most importantly, this integrated approach provides a solid foundation in age-sensitive care along with opportunities to apply these concepts in the clinical setting and develop positive attitudes toward older adults.14
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References 1. Burbank PM, Dowling-Castronovo A, Crowther MR, Capezuti EA. Improving knowledge and attitudes toward older adults through innovative educational strategies. J Prof Nurs. 2006;22(2):91-97. 2. McCleary L, McGilton K, Boscart V, Oudshoorn A. Improving gerontology content in baccalaureate nursing education through knowledge transfer to nurse educators. Nurs Leadersh. 2009; 22(3):33-46. 3. Administration on Aging. Projected future growth of the older population. Available at http://www.aoa.gov/AoARoot/Aging_ Statistics/future_growth/future_growth.aspx. Accessed August 1, 2013. 4. Centers for Disease Control and Prevention. Health, United States, 2010 with special feature on death and dying. 2010. Available at http://www.cdc.gov/nchs/data/hus/hus10.pdf. Accessed August 1, 2013. 5. Lovell M. Caring for the elderly: changing perceptions and attitudes. J Vasc Nurs. 2006;24:22-26. 6. Evers C, Ploeg J, Kaasalainen S. Case study of attitudes and values of nursing students towards caring for older adults. J Nurs Educ. 2011;50(7):404-409. 7. Brown J, Nolan M, Savies S, Nolan J, Keady J. Transforming students’ views of gerontological nursing: realising the potential of ‘enriched’ environments of learning and care: a multi-method longitudinal study. Int J Nurs Stud. 2008;45:1214-1232. 8. Davis RL, Beel-Bates C, Jensen S. The Longitudinal Elder Initiative: helping students learn to care for older adults. J Nurs Educ. 2008;47(4):179-182. 9. Mezey M, Bickford C, Schumann MJ, Mariano C, Handberg E, Sutermaster DJ. Specialty nursing scope and standards of practice: incorporating content about the care of older adults. Gerontol Nurs. 2007;28(6S):23-28. 10. American Nurses Association. Gerontological nursing practice: scope and standards of practice. Available at http://geronurseonline .org. Accessed August 1, 2013. 11. American Association of Colleges of Nursing, Harford Institute for Geriatric Nursing. Recommended baccalaureate competencies and curricular guidelines for the nursing care of older adults: a supplement to the essentials of baccalaureate education for professional nursing practice, September 2010. Available at http:// www.aacn.nche.edu/geriatric-nursing/AACN_Gerocompetencies .pdf. Accessed August 1, 2013. 12. Kapoun J. Five criteria for evaluating Web pages. Available at http://olinuris.library.cornell.edu/ref/research/webcrit.html. Accessed August 1, 2013. 13. National Institutes on Aging. Health and aging. Available at www.nia.nih.gov/HealthInformation/Publications. Accessed August 1, 2013. 14. Williams KN, Nowak J, Scobee RL. Fostering student interest in geriatric nursing: impact of senior long-term care experiences. Nurs Educ Perspect. 2006;27(4):190-193.
Nurse Educator
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
Nurse Educator
Teaching Strategies
Creating a New View of Aging Mary C. DiBartolo, PhD, RN-BC, CNE Lisa A. Seldomridge, PhD, RN
Mary C. DiBartolo
Lisa A. Seldomridge
T
he older adult population represents a core segment of healthcare, yet few nurses are adequately prepared to tend to their unique needs.1,2 Presently, people older than 65 years comprise 12% of the population, with those numbers expected to double by 2030.3 As older adults live longer and with a variety of chronic illnesses, they will continue to use healthcare services, comprising more than 50% of all hospital days, 60% of primary care visits, and 70% of home care visits.4 These healthcare trends place an unprecedented demand for nurses to provide optimal care to this complex population.1,5,6 As a result, nursing programs are challenged to include evidence-based content and experiences to produce nursing professionals who provide ageappropriate, culturally competent care to meet the multifaceted needs of the aging community.7-11 After attending a Geriatric Nursing Education Consortium (GNEC), faculty at our mid-Atlantic university undertook ‘‘gerontologizing’’ their curriculum. The authors describe several assignments developed for the first adult health course in the baccalaureate nursing program blending theoretical and experiential learning to increase students’ knowledge, skills, and sensitivity in caring for older adults.
Description of Assignments Students begin the nursing curriculum with 3 credits each for adult health theory and clinical. Learning in the theory course is applied in the corresponding clinical course. In the first week of class, concepts related to caring for older adults are introduced using materials from the GNEC Web site. Topics include statistics supporting the geriatric imperative; myths and stereotypes associated with aging; biologic, sociologic, and psychological changes of aging; geriatric syndromes; and the American Association of Colleges of Nursing Gerontology Core Competencies.11 This discussion sets the stage for
Authors Affiliations: Professor (Drs DiBartolo and Seldomridge), Department of Nursing, Salisbury University, Maryland. The authors declare no conflicts of interest. Correspondence: Dr DiBartolo, Department of Nursing, Salisbury University, 1101 Camden Ave, Salisbury, MD 21801 (mcdibartolo@ salisbury.edu). DOI: 10.1097/01.NNE.0000435262.07871.70
Nurse Educator
upcoming experiential learning. In week 2, as part of the clinical course, students engage in a 2-hour Aging Sensitivity Simulation and Training for a first-hand experience with common changes of aging. Designed by RNs from the Eastern Shore Area Health Education Consortium, the simulation is used in a variety of settings to help caregivers gain awareness and compassion regarding caring for older adults. By donning glasses that mimic visual disturbances (presbyopia, cataracts, and macular degeneration), students begin to appreciate how routine activities are affected and might require modification. Wearing gloves with cotton balls in the fingertips (simulated arthritis), students must dress themselves in a button-up shirt, dial a telephone, open a child-proof medication bottle, and count out candy ‘‘pills’’ to fill a weekly medication dispenser. After rotating through 10 stations, students are debriefed with a focus on how they felt during the experience, what activities were the most difficult, what helped or hindered accomplishing each activity (A. Wahl, MSW, oral communication, September 2012). Participation in this experience was counted as part of a clinical day. In weeks 3 and 4 of the theory course, students embark on a GeroWeb scavenger hunt. Composed of 4 components, this activity introduces students to Web-based resources that could be helpful in working with older adults and their families and assists students in critical analysis of those Web sites. For component 1, students located a Web site of a nonprofit organization that provided information on a health condition commonly associated with older adults that was also being discussed in the adult health theory course. Examples included the American Heart Association, Arthritis Foundation, and Alzheimer’s Association. Students wrote 1 paragraph describing the kind of information available on the site and 1 paragraph on how the information could be useful to older adults and their families. Next, students were directed to a Web site with criteria for evaluating the quality of Web-based materials based on accuracy, authority, objectivity, currency, and coverage12 and were to apply these to the nonprofit organization Web site. For the second component, students were given a list of peer-reviewed nursing journals with a geriatric focus and directed to find a recently published article on an illness/condition associated with older adults. Students then wrote a brief summary of Volume 38 & Number 6 & November/December 2013
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
237
key points covered in the article and how the article would be useful to their nursing practice. The third component required navigation to the National Institute on Aging13 Web site to browse the ‘‘Age Pages’’ for a topic of interest. Students summarized the ‘‘Age Page’’ and discussed how the information would be useful for older adults and their families. The fourth component involved visiting the Hartford Foundation sponsored Web site (www .ConsultGeriRN.org) and exploring the section ‘‘Try This: Best Practices in Nursing Care to Older Adults,’’ where students could access 26 different assessment instruments/topics focusing on various geriatric issues such as Fulmer Spices Overall Assessment of Older Adults, Geriatric Depression Scale, or Fall Risk Assessment. After identifying an assessment instrument of interest, students wrote a brief description and discussed how they might use it in caring for an older adult. At the ‘‘Try This’’ Web site, students also had the option of watching a video clip demonstration of a nurse administering the instrument with an older adult client. Students submitted all 4 components at 1 time, and the project counted 10% toward their theory course grade. However, each component could be submitted separately with discussion of what students found during clinical conferences. During weeks 5 and 6 of the clinical course, students visited a community-based senior center and interviewed 1 of the participants. The initial encounter focused on establishing a professional relationship and using interviewing skills to take a medication and/or nutrition history. After analysis and discussion with faculty, students developed a teaching plan using resources gathered through the GeroWeb scavenger hunt. Upon return to the senior center 1 week later, students met their older adult client and provided education on identified knowledge deficits related to medications and/or nutrition.
Conclusion Research has shown that nursing students who experience ‘‘enriched’’ environments for learning, where they are exposed to evidence-based geriatric care standards and appropriate attitudes toward the aging population, are far more likely to view care of older adults in a favorable light.7 Although these activities focused on community-dwelling healthy older adults, they could easily be adapted to other settings. Most importantly, this integrated approach provides a solid foundation in age-sensitive care along with opportunities to apply these concepts in the clinical setting and develop positive attitudes toward older adults.14
238
Volume 38 & Number 6 & November/December 2013
References 1. Burbank PM, Dowling-Castronovo A, Crowther MR, Capezuti EA. Improving knowledge and attitudes toward older adults through innovative educational strategies. J Prof Nurs. 2006;22(2):91-97. 2. McCleary L, McGilton K, Boscart V, Oudshoorn A. Improving gerontology content in baccalaureate nursing education through knowledge transfer to nurse educators. Nurs Leadersh. 2009; 22(3):33-46. 3. Administration on Aging. Projected future growth of the older population. Available at http://www.aoa.gov/AoARoot/Aging_ Statistics/future_growth/future_growth.aspx. Accessed August 1, 2013. 4. Centers for Disease Control and Prevention. Health, United States, 2010 with special feature on death and dying. 2010. Available at http://www.cdc.gov/nchs/data/hus/hus10.pdf. Accessed August 1, 2013. 5. Lovell M. Caring for the elderly: changing perceptions and attitudes. J Vasc Nurs. 2006;24:22-26. 6. Evers C, Ploeg J, Kaasalainen S. Case study of attitudes and values of nursing students towards caring for older adults. J Nurs Educ. 2011;50(7):404-409. 7. Brown J, Nolan M, Savies S, Nolan J, Keady J. Transforming students’ views of gerontological nursing: realising the potential of ‘enriched’ environments of learning and care: a multi-method longitudinal study. Int J Nurs Stud. 2008;45:1214-1232. 8. Davis RL, Beel-Bates C, Jensen S. The Longitudinal Elder Initiative: helping students learn to care for older adults. J Nurs Educ. 2008;47(4):179-182. 9. Mezey M, Bickford C, Schumann MJ, Mariano C, Handberg E, Sutermaster DJ. Specialty nursing scope and standards of practice: incorporating content about the care of older adults. Gerontol Nurs. 2007;28(6S):23-28. 10. American Nurses Association. Gerontological nursing practice: scope and standards of practice. Available at http://geronurseonline .org. Accessed August 1, 2013. 11. American Association of Colleges of Nursing, Harford Institute for Geriatric Nursing. Recommended baccalaureate competencies and curricular guidelines for the nursing care of older adults: a supplement to the essentials of baccalaureate education for professional nursing practice, September 2010. Available at http:// www.aacn.nche.edu/geriatric-nursing/AACN_Gerocompetencies .pdf. Accessed August 1, 2013. 12. Kapoun J. Five criteria for evaluating Web pages. Available at http://olinuris.library.cornell.edu/ref/research/webcrit.html. Accessed August 1, 2013. 13. National Institutes on Aging. Health and aging. Available at www.nia.nih.gov/HealthInformation/Publications. Accessed August 1, 2013. 14. Williams KN, Nowak J, Scobee RL. Fostering student interest in geriatric nursing: impact of senior long-term care experiences. Nurs Educ Perspect. 2006;27(4):190-193.
Nurse Educator
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
