Practicum Update: SUNY Ulster, Health Alliance Hospital, and RAM

During the first week, there was a lot of planning occurring between my preceptor at SUNY
Ulster, Dr. Digger, and other classmates regarding RAM, RAM transportation, and pick up times
etc. In the second week, I spent a day with my preceptor who gave two, three hour lectures. One
was for the fourth semester nursing students, and the other was pharmacology. I was interested
in observing these lectures as I have never really looked at a lecture from the eyes of an educator,
it has always been as a student gathering information. This was interesting because the nursing
lecture was given as a team teaching strategy. I had never seen this strategy used before, I had
only read about in articles and the text book. It was nice to see this teaching method in action.
They both work to create the lecture together, then there is a main lecturer, and then the co-
lecturer so to speak. The co-lecturer adds input as she sees fit throughout the lecture. The next
class the co-lecturer and lecturer will switch positions. This type of teaching is occurring more
often with the concept of having to teach more students with less resources (Robb & Gerwick,
2013). Where are there are many advantages to this type of teaching sometimes it just cannot
work and there are of course disadvantages. If instructors are teamed up with people who have a
different idea or style of teaching this can be a problem, or if there is conflict between the team
this can also create issues causing a disadvantage (Robb & Gerwick).
The pharmacology course uses a flipped classroom. There is a small online component to the
class where the students complete online activities, view information, and come back to class and
go into more detail and depth in the classroom. In a flipped classroom studies have shown that
there is more interaction in the class as well as students being more prepared for the class
(OFlaherty & Phillips, 2015). This was in fact true of my observation of the students in the
pharmacology class. The students seem to like this type of teaching, as there is definitely more
class participation occurring, and the class seems all together more prepared. This is much
different than the students seeing the information for the first time or not really having a good
grasp on the material prior to class as I saw earlier in the morning in the nursing lecture.
Week two was mainly the Remote Area Medical (RAM) volunteer experience in Knoxville,
Tennessee. This was a very beneficial learning experience for myself and my classmates as well.
This really reinforced the importance of giving back and serving the community as an advanced
practice nurse. The first day of the two-day event I worked in general medical where I checked
in patients to be seen by the doctor, NP, or PA. I would also re-check blood sugars as well.
During this I was able to see what went into an event of this scale and the team work that needed
to occur to be able to see 1100 people in need of medical, dental and vision care. The second day
I manned the station where I checked peoples coumadin level via a finger stick. I have been
thinking over the past couple of weeks of possibly getting a clinic together in the Poughkeepsie,
or Newburgh area. Two areas that can certainly benefit from this service. According to the
Census Bureau, there are over 21% of the population without access to healthcare in the
Newburgh area and 16.4% without access in the Poughkeepsie area (United States Census
Bureau, 2015a; United States Census Bureau, 2015b). These statistics confirmed my inclination
that these two geographical areas would benefit from the inception of a RAM clinic.
During week three I was involved in a second semester nursing clinical at Health Alliance
Hospital where I assisted the students with any questions they had regarding their patients, or
history and physicals they were reading. It was hard for me to go back and understand that they
really had minimal knowledge when it came to what their role as an RN would be since they are
just in their second semester. I have to remember that a genuinely deeper understanding wont
come until their last year in the program on most occasions (Beer & Martensson, 2015).
Everyone was very hung up on giving a.m. care, but I constantly had to refocus them, and while
a.m. care is important, when they first come on shift they need to briefly see their patients and do
a head to toe assessment. I found that preparing nursing students for person-centered care is a
key concern for educators at nursing faculties around the world (Theander et al., 2016 para 8).
Therefore, it is good to see that I am not alone. I lead post conference where everyone went
around the table and shared their SBAR report on their patient and anything interesting that may
have happened, or things the other students could learn from. During this I asked questions to
get them to critically think, such as why hasnt this particular patient had a bowel movement?
Asking them what perhaps contributed to this occurring etc. By giving feedback and asking
questions during post conference encourages clinical reasoning, and input on how to improve
their practice (Beer & Martensson, 2015). This really interested me, and I had a really great and
positive experience seeing the students put the pieces of the puzzle together to better their skills
and critical thinking.
This week I was supposed to go to the clinical area again, but due to weather that was cancelled
on Monday. So, Friday I will be doing a presentation about the RAM experience, and the
importance of service to others after the students get out of school. I will be making a
PowerPoint presentation and I have brochures at the print shop to be printed to pass out. This
will take place in the lab, as well as during the nursing club meeting. Im excited (and nervous)
to get out of my comfort zone and do this presentation.
~Jenn

References
Beer, M., & Mrtensson, L. (2015). Feedback on students' clinical reasoning skills during
fieldwork education. Australian Occupational Therapy Journal, 62(4), 255-264.
doi:10.1111/1440-1630.12208
O'Flaherty, J., & Phillips, C. (2015). The use of flipped classrooms in higher education: A
scoping review. The Internet and Higher Education, 25, 85-95. doi:10.1016/j.iheduc.2015.02.002
Robb, M., & Gerwick, M. (2013). Team teaching: A resource guide for nurse educators.
Teaching and Learning in Nursing, 8(3), 78-82. doi:10.1016/j.teln.2013.04.005
Theander, K., Wilde-Larsson, B., Carlsson, M., Florin, J., Gardulf, A., Johansson, E., & ...
Nilsson, J. (2016). Adjusting to future demands in healthcare: Curriculum changes and nursing
students' self-reported professional competence. Nurse Education Today, 37, 178-183.
doi:10.1016/j.nedt.2015.11.012
United States Census Bureau. (2015a). Quick facts Newburgh city, New York. Retrieved from
http://www.census.gov/quickfacts/table/RHI105210/3650034
United States Census Bureau. (2015b). Quick facts Poughkeepsie city, New York. Retrieved from
http://www.census.gov/quickfacts/table/LND110210/3659641