- Email: [email protected]
Mock Board Hearing: Giving Students New Insights Through Experiential Learning
Clinical Simulation in Nursing (2014) 10, 630-633
www.elsevier.com/locate/ecsn
Featured Article
Mock Board Hearing: Giving Students New Insights Through Experiential Learning Shelley D. Jordan, JD, MSN, RNa, Angela S. Collins-Yoder, PhD, RN, CCNS, ACNS BCb,* a
Director of Advancement and Instructor, The University of Alabama, Capstone College of Nursing, Tuscaloosa, AL 35487-0358, USA b Clinical Professor and Critical Care Clinical Nurse Specialist, The University of Alabama, Capstone College of Nursing, Tuscaloosa, AL 35487-0358, USA KEYWORDS mock board hearing; experiential learning; legal issues in nursing; board of nursing; drug impairment; nursing students; simulation
Abstract: Engaging students in learning the interface of nursing practice with the regulatory role of boards of nursing is a desired learning outcome of baccalaureate education. Kolb’s experiential theory was the catalyst to design a teaching method for this content. The innovative learning strategy that mimics simulation techniques used in legal education is the mock proceeding technique. The aspect covered in the script of the mock proceeding was a nurse with a positive drug test. Colleges of law, have utilized mock trial methods to assist their students to engage the complexities of process of trial and administrative law. This is a description of the steps in the process that occurred to allow this learning strategy to occur and discusses some of the outcomes that were noted. Cite this article: Jordan, S. D., & Collins-Yoder, A. S. (2014, December). Mock board hearing: Giving students new insights through experiential learning. Clinical Simulation in Nursing, 10(12), 630-633. http:// dx.doi.org/10.1016/j.ecns.2014.09.005. Ó 2014 International Nursing Association for Clinical Simulation and Learning. Published by Elsevier Inc. All rights reserved.
Knowledge of the role of Boards of Nursing (BON) that govern nursing practice is one of the desired outcomes of baccalaureate education (American Association of Colleges of Nursing [AACN], 2008). Professional practice mandates a working understanding of the responsibility and accountability that comes with RN licensure. There is a lack of knowledge among students about the function and scope of the Boards of Nursing. Boards of Nursing regulatory procedures are a category of law called administrative law, which is not depicted in media. Additionally, one frequent issue handled by Boards of Nursing is drug-impaired nurses
* Corresponding author: [email protected] (A. S. Collins-Yoder).
(Boulton & Nosek, 2014). Kolb’s theory of experiential learning provided a useful compass to design a teaching strategy to address these deficits. This theory states that ‘‘learning is the process whereby knowledge is created through the transformation of experience’’ (Kolb, 1984, pp 38). Simulation can be a starting point for experiential learning (Lisko & O’Dell, 2010; Jenkins & Lemak, 2009) (Figure 1). Experiential learning opportunities are important components of both nursing and legal education (Apel, 2011). In law schools, exercises such as mock trials, moot court, and alternative dispute resolutions, all simulation formats, are designed to teach students the skills they will use in practice (Williams, 1984). In nursing education, simulation is also a
1876-1399/$ - see front matter Ó 2014 International Nursing Association for Clinical Simulation and Learning. Published by Elsevier Inc. All rights reserved.
http://dx.doi.org/10.1016/j.ecns.2014.09.005
Mock Board Hearing
631
teaching strategy encouraged by external mandates (Institute of Medicine (IOM), 2010). The purpose of this article was to describe the use of a mock board hearing in nursing education. The objectives of the hearing were to Key points Legal proceedings are often taught by using the ‘‘mock trial’’ method which is a type of simulation. This method of learning is experiential in design and Kolb’s theory of learning is the foundation for this education strategy. This article is a description of a collaboration between a board of nursing, nursing faculty, and legal colleagues.
1. Introduce the students to the regulatory scope of the Boards of Nursing 2. Reveal the process of an administrative board hearing 3. Exhibit the consequences of how a personal decision by a RN to use an illegal substance may result in licensure restriction, suspension, or revocation.
4
Testing in New Situations
Methods
Concrete Experience
Kolbs’s Experiential Learning Cycle
3 Forming Abstract Concepts
Figure 1
Students
Hearing Officer
(Table) Respondent RN
Figure 2
Attorney for Respondent
BON Officer
Room configuration, BON, Board of Nursing.
Results This teaching strategy presents an experience that simulates reality. After the mock hearing, the student reflects with intention. This internal reflection is broadened by the
Nurses using recreational drugs are a sensitive issue in health care (Crigger & Godfrey, 2014; National Council State Boards of Nursing (NCSBN), 2011). Knowing this, the authors met with college administrators to discuss the proposed teaching strategy and objectives. The chosen course was Leadership, the preceptorship component for students in their final semester. This curriculum alignment places the content foremost in the students’ minds before licensure. The identified roles in the mock board hearing were legal counsel for the Boards of Nursing, opposing counsel, respondent RN, the Hearing Officer, and a faculty member to facilitate the discussion. The classroom was configured in keeping with the Boards of Nursing specifications (Figure 2). The enactment took 30 minutes and concluded with a 30-minute classroom discussion (Table).
1
Mock Board Hearing: Room Schematic
2 Observation and Reflection
Table
Excerpt From Mock Board Script
Hearing Officer: We’re here for the matter involving Nicole Green License number 987654. I’ll take appearances for the record. Ms. Jordan: Shirley Jordan for the respondent Nicole Green. Ms. Williams: Gilda Williams for the Board of Nursing. Ms. Williams: I have talked with Ms. Shirley Jordan, attorney for Nicole Green, and she agrees to the charges as written and to the following stipulated facts: That Nicole Green license number 987654 is a licensee of the Board of Nursing. She was originally licensed on or about July 3, 2012. Said license was current at all times pertinent to the allegations in the statement of charges. She is currently licensed through December the 31st 2014. What we expect to establish by these stipulated facts is that on November 2, 2013 while employed as a registered nurse at HMC hospital, she tested positive for marijuana on a post-accident urine drug screen and that information was received at the Board from a Brittany Burnett. Brittany Burnett is the nursing coordinator for HMC hospital. She sent a letter to the Board, which was received on November 10, 2013. In this letter, she states that Nicole Green had a positive drug test for marijuana. The result was also sent to a Dr. Betty Single for independent confirmation as well. Brittany further noted that HMC terminated Nicole Green’s employment since it was contingent upon her passing the drug test. These results are contained in Board’s Exhibit #2. Board’s Exhibit #1 is the statement of charges that gave notice of today’s hearing date, time, and place, of a February 8, 2014 date for 10:00 a.m. Board’s Exhibits #3 and #4 show receipt of same and acknowledgment of it by her attorney, Shirley Jordan and that the case would be continued to today’s date. We have a positive drug screen and Nicole Green would like to present her case and tell her story.
Kolb’s theory.
pp 630-633 Clinical Simulation in Nursing Volume 10 Issue 12
Mock Board Hearing
632
1
Preparation for obtaining license – Personal accountability 4
Concrete Experience
Participation in Mock Board Hearing
Kolbs’s Experiential Learning Cycle
Testing in
New Situations
2
Observation and Reflection
Class discussion Bulletin Board
3
Forming Abstract Concepts Figure 3
“What if” question?
Alignment of Simulation Strategy with Kolb’s Theory.
decision not to present a final ruling in the case (reflective observation). The student is encouraged to deliberate and look at every possible outcome. The option of not presenting an outcome was suggested by our legal colleagues. In the teaching of legal content, novice attorneys are encouraged to envision all possible outcomes of the decision in the case. Posing the question ‘‘What if’’ stimulates critical thinking. Both faculty and students propose questions and scenarios during classroom discussion, and comments relevant to the process are posted on the electronic bulletin board (abstract conceptualization). Two anonymous postings on the discussion board were ‘‘Today, I understood that I have one life, and that personal and professional are intertwined. It’s very important to be conscious of who you surround yourself with. I saw that one mistake can have extreme repercussions.’’ ‘‘I learned that I will be honest on my application when applying for my license. As a nurse we need to live one life, no two different lives. We need to act appropriately outside of work, just as we would if we were at work. I will take my license very seriously because I worked four hard years to get it.’’ After four semesters utilizing this teaching strategy, student engagement with the course content has significantly improved as noted in the course evaluations. The course consistently received high participation in both the classroom as well as the follow-up reflective discussions on the electronic bulletin board. The students stated that their understanding of the regulatory scope of the Boards of Nursing had increased. The recurring theme, in discussions both live and online, was a lack of awareness that personal
and professional lives are intertwined and could result in a loss of license. The authors believe that the deficits identified before implementing this teaching strategy were met as evidenced by students’ interaction through questions, dialog, and electronic postings. We introduced the students to the regulatory scope of the Boards of Nursing. The hearing process was revealed through simulation of actual proceedings. Students’ reflective thoughts and discussions told of new insights related to the concepts of personal accountability and transparency between personal and professional life (Figure 3).
Acknowledgments We would like to acknowledgments our colleagues Michelle Cheshire, Genell Lee, Alice Maples, Felicia Wood and Linda Patterson.
References Apel, S. (2011). No more casebooks: Using simulation-based learning to educate future family law practitioners. Family Court Review, 49(4), 700-710. Boulton, M. A., & Nosek, L. J. (2014). How do nursing students perceive substance abusing nurses? Archives of Psychiatric Nursing, 28(1), 2934. http://dx.doi.org/10.1016/j.apnu.2013.10.005. Crigger, N., & Godfrey, N. S. (2014). Professional wrongdoing: Reconciliation and recovery. Journal of Nursing Regulation, 4(4), 40-47. Institute of Medicine. (2010). The future of nursing leading change, advancing health, report recommendations. Washington, DC: National Academies Press. Jenkins, R., & Lemak, C. (2009). A malpractice lawsuit simulation: Critical care providers learn as participants in a mock trial. Critical Care Nurse, 29(4), 52-60.
pp 630-633 Clinical Simulation in Nursing Volume 10 Issue 12
Mock Board Hearing
633
Kolb, D. A. (1984). Experiential learning: Experience as the source of learning and development. Englewood Cliffs, NJ: Prentice Hall. Lisko, S., & O’Dell, V. (2010). Integration of theory and practice: Experiential learning theory and nursing education. Nursing Education Perspectives, 31(2), 106-108. National Council State Boards of Nursing. (2011). Substance use disorder in nursing: A resource manual and guidelines for alternatives, discipline,
and monitoring programs. Chicago, Il : Retreived from https://www. ncsbn.org/SUDN_11.pdf The American Association of Colleges of Nursing. (2008). The essentials of baccalaureate education for professional nursing practice. Washington, DC. Williams, G. (1984). Using simulation exercises for negotiation and other dispute resolution courses. Journal of Legal Education, 34, 307-314.
pp 630-633 Clinical Simulation in Nursing Volume 10 Issue 12
www.elsevier.com/locate/ecsn
Featured Article
Mock Board Hearing: Giving Students New Insights Through Experiential Learning Shelley D. Jordan, JD, MSN, RNa, Angela S. Collins-Yoder, PhD, RN, CCNS, ACNS BCb,* a
Director of Advancement and Instructor, The University of Alabama, Capstone College of Nursing, Tuscaloosa, AL 35487-0358, USA b Clinical Professor and Critical Care Clinical Nurse Specialist, The University of Alabama, Capstone College of Nursing, Tuscaloosa, AL 35487-0358, USA KEYWORDS mock board hearing; experiential learning; legal issues in nursing; board of nursing; drug impairment; nursing students; simulation
Abstract: Engaging students in learning the interface of nursing practice with the regulatory role of boards of nursing is a desired learning outcome of baccalaureate education. Kolb’s experiential theory was the catalyst to design a teaching method for this content. The innovative learning strategy that mimics simulation techniques used in legal education is the mock proceeding technique. The aspect covered in the script of the mock proceeding was a nurse with a positive drug test. Colleges of law, have utilized mock trial methods to assist their students to engage the complexities of process of trial and administrative law. This is a description of the steps in the process that occurred to allow this learning strategy to occur and discusses some of the outcomes that were noted. Cite this article: Jordan, S. D., & Collins-Yoder, A. S. (2014, December). Mock board hearing: Giving students new insights through experiential learning. Clinical Simulation in Nursing, 10(12), 630-633. http:// dx.doi.org/10.1016/j.ecns.2014.09.005. Ó 2014 International Nursing Association for Clinical Simulation and Learning. Published by Elsevier Inc. All rights reserved.
Knowledge of the role of Boards of Nursing (BON) that govern nursing practice is one of the desired outcomes of baccalaureate education (American Association of Colleges of Nursing [AACN], 2008). Professional practice mandates a working understanding of the responsibility and accountability that comes with RN licensure. There is a lack of knowledge among students about the function and scope of the Boards of Nursing. Boards of Nursing regulatory procedures are a category of law called administrative law, which is not depicted in media. Additionally, one frequent issue handled by Boards of Nursing is drug-impaired nurses
* Corresponding author: [email protected] (A. S. Collins-Yoder).
(Boulton & Nosek, 2014). Kolb’s theory of experiential learning provided a useful compass to design a teaching strategy to address these deficits. This theory states that ‘‘learning is the process whereby knowledge is created through the transformation of experience’’ (Kolb, 1984, pp 38). Simulation can be a starting point for experiential learning (Lisko & O’Dell, 2010; Jenkins & Lemak, 2009) (Figure 1). Experiential learning opportunities are important components of both nursing and legal education (Apel, 2011). In law schools, exercises such as mock trials, moot court, and alternative dispute resolutions, all simulation formats, are designed to teach students the skills they will use in practice (Williams, 1984). In nursing education, simulation is also a
1876-1399/$ - see front matter Ó 2014 International Nursing Association for Clinical Simulation and Learning. Published by Elsevier Inc. All rights reserved.
http://dx.doi.org/10.1016/j.ecns.2014.09.005
Mock Board Hearing
631
teaching strategy encouraged by external mandates (Institute of Medicine (IOM), 2010). The purpose of this article was to describe the use of a mock board hearing in nursing education. The objectives of the hearing were to Key points Legal proceedings are often taught by using the ‘‘mock trial’’ method which is a type of simulation. This method of learning is experiential in design and Kolb’s theory of learning is the foundation for this education strategy. This article is a description of a collaboration between a board of nursing, nursing faculty, and legal colleagues.
1. Introduce the students to the regulatory scope of the Boards of Nursing 2. Reveal the process of an administrative board hearing 3. Exhibit the consequences of how a personal decision by a RN to use an illegal substance may result in licensure restriction, suspension, or revocation.
4
Testing in New Situations
Methods
Concrete Experience
Kolbs’s Experiential Learning Cycle
3 Forming Abstract Concepts
Figure 1
Students
Hearing Officer
(Table) Respondent RN
Figure 2
Attorney for Respondent
BON Officer
Room configuration, BON, Board of Nursing.
Results This teaching strategy presents an experience that simulates reality. After the mock hearing, the student reflects with intention. This internal reflection is broadened by the
Nurses using recreational drugs are a sensitive issue in health care (Crigger & Godfrey, 2014; National Council State Boards of Nursing (NCSBN), 2011). Knowing this, the authors met with college administrators to discuss the proposed teaching strategy and objectives. The chosen course was Leadership, the preceptorship component for students in their final semester. This curriculum alignment places the content foremost in the students’ minds before licensure. The identified roles in the mock board hearing were legal counsel for the Boards of Nursing, opposing counsel, respondent RN, the Hearing Officer, and a faculty member to facilitate the discussion. The classroom was configured in keeping with the Boards of Nursing specifications (Figure 2). The enactment took 30 minutes and concluded with a 30-minute classroom discussion (Table).
1
Mock Board Hearing: Room Schematic
2 Observation and Reflection
Table
Excerpt From Mock Board Script
Hearing Officer: We’re here for the matter involving Nicole Green License number 987654. I’ll take appearances for the record. Ms. Jordan: Shirley Jordan for the respondent Nicole Green. Ms. Williams: Gilda Williams for the Board of Nursing. Ms. Williams: I have talked with Ms. Shirley Jordan, attorney for Nicole Green, and she agrees to the charges as written and to the following stipulated facts: That Nicole Green license number 987654 is a licensee of the Board of Nursing. She was originally licensed on or about July 3, 2012. Said license was current at all times pertinent to the allegations in the statement of charges. She is currently licensed through December the 31st 2014. What we expect to establish by these stipulated facts is that on November 2, 2013 while employed as a registered nurse at HMC hospital, she tested positive for marijuana on a post-accident urine drug screen and that information was received at the Board from a Brittany Burnett. Brittany Burnett is the nursing coordinator for HMC hospital. She sent a letter to the Board, which was received on November 10, 2013. In this letter, she states that Nicole Green had a positive drug test for marijuana. The result was also sent to a Dr. Betty Single for independent confirmation as well. Brittany further noted that HMC terminated Nicole Green’s employment since it was contingent upon her passing the drug test. These results are contained in Board’s Exhibit #2. Board’s Exhibit #1 is the statement of charges that gave notice of today’s hearing date, time, and place, of a February 8, 2014 date for 10:00 a.m. Board’s Exhibits #3 and #4 show receipt of same and acknowledgment of it by her attorney, Shirley Jordan and that the case would be continued to today’s date. We have a positive drug screen and Nicole Green would like to present her case and tell her story.
Kolb’s theory.
pp 630-633 Clinical Simulation in Nursing Volume 10 Issue 12
Mock Board Hearing
632
1
Preparation for obtaining license – Personal accountability 4
Concrete Experience
Participation in Mock Board Hearing
Kolbs’s Experiential Learning Cycle
Testing in
New Situations
2
Observation and Reflection
Class discussion Bulletin Board
3
Forming Abstract Concepts Figure 3
“What if” question?
Alignment of Simulation Strategy with Kolb’s Theory.
decision not to present a final ruling in the case (reflective observation). The student is encouraged to deliberate and look at every possible outcome. The option of not presenting an outcome was suggested by our legal colleagues. In the teaching of legal content, novice attorneys are encouraged to envision all possible outcomes of the decision in the case. Posing the question ‘‘What if’’ stimulates critical thinking. Both faculty and students propose questions and scenarios during classroom discussion, and comments relevant to the process are posted on the electronic bulletin board (abstract conceptualization). Two anonymous postings on the discussion board were ‘‘Today, I understood that I have one life, and that personal and professional are intertwined. It’s very important to be conscious of who you surround yourself with. I saw that one mistake can have extreme repercussions.’’ ‘‘I learned that I will be honest on my application when applying for my license. As a nurse we need to live one life, no two different lives. We need to act appropriately outside of work, just as we would if we were at work. I will take my license very seriously because I worked four hard years to get it.’’ After four semesters utilizing this teaching strategy, student engagement with the course content has significantly improved as noted in the course evaluations. The course consistently received high participation in both the classroom as well as the follow-up reflective discussions on the electronic bulletin board. The students stated that their understanding of the regulatory scope of the Boards of Nursing had increased. The recurring theme, in discussions both live and online, was a lack of awareness that personal
and professional lives are intertwined and could result in a loss of license. The authors believe that the deficits identified before implementing this teaching strategy were met as evidenced by students’ interaction through questions, dialog, and electronic postings. We introduced the students to the regulatory scope of the Boards of Nursing. The hearing process was revealed through simulation of actual proceedings. Students’ reflective thoughts and discussions told of new insights related to the concepts of personal accountability and transparency between personal and professional life (Figure 3).
Acknowledgments We would like to acknowledgments our colleagues Michelle Cheshire, Genell Lee, Alice Maples, Felicia Wood and Linda Patterson.
References Apel, S. (2011). No more casebooks: Using simulation-based learning to educate future family law practitioners. Family Court Review, 49(4), 700-710. Boulton, M. A., & Nosek, L. J. (2014). How do nursing students perceive substance abusing nurses? Archives of Psychiatric Nursing, 28(1), 2934. http://dx.doi.org/10.1016/j.apnu.2013.10.005. Crigger, N., & Godfrey, N. S. (2014). Professional wrongdoing: Reconciliation and recovery. Journal of Nursing Regulation, 4(4), 40-47. Institute of Medicine. (2010). The future of nursing leading change, advancing health, report recommendations. Washington, DC: National Academies Press. Jenkins, R., & Lemak, C. (2009). A malpractice lawsuit simulation: Critical care providers learn as participants in a mock trial. Critical Care Nurse, 29(4), 52-60.
pp 630-633 Clinical Simulation in Nursing Volume 10 Issue 12
Mock Board Hearing
633
Kolb, D. A. (1984). Experiential learning: Experience as the source of learning and development. Englewood Cliffs, NJ: Prentice Hall. Lisko, S., & O’Dell, V. (2010). Integration of theory and practice: Experiential learning theory and nursing education. Nursing Education Perspectives, 31(2), 106-108. National Council State Boards of Nursing. (2011). Substance use disorder in nursing: A resource manual and guidelines for alternatives, discipline,
and monitoring programs. Chicago, Il : Retreived from https://www. ncsbn.org/SUDN_11.pdf The American Association of Colleges of Nursing. (2008). The essentials of baccalaureate education for professional nursing practice. Washington, DC. Williams, G. (1984). Using simulation exercises for negotiation and other dispute resolution courses. Journal of Legal Education, 34, 307-314.
pp 630-633 Clinical Simulation in Nursing Volume 10 Issue 12