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Patient-Centered Care: Creating Human-Based Learning Activities

What a funny title: “human-based learning activities.”

But think about it. We teach pathophysiology, pharmacology, care planning, skills, and the list goes on. Oftentimes, the student can get lost in the content and forget the patient. Given the intensity of nursing school, many students find themselves in a situation where they forget to pursue patient-centered care.

The concept of patient-centered care (PCC) is best addressed at www.QSEN.org. It explains how the nurse makes the client a part of the healthcare team. There are competencies related to the nurse having positive attitudes about the patient and valuing what the patient brings to the management of care.

As educators, there is a strong need to ensure that students are addressing PCC daily throughout nursing school. Many of us can remember the advertisements from the Joint Commission on how patients who were more involved were less likely to experience an adverse event in the healthcare process.

One of the best strategies to bring PCC into every lecture classroom experience is to bring a simulation patient to class. If the instructor can bring the mannequin, that is great. But if not, the patient from the sim lab can still come to class.

For example, let’s say the instructor in fundamentals is teaching about oxygenation. That instructor can go to the lab and discover that the Simulation Learning System has multiple sims where the client has oxygenation needs. These simulations in the lab are often complete with many different learning objects. The instructor can share the scenario with the students and ask the students to focus on some aspect of the patient’s background or situation that could impact outcomes.

For instance, a single mother with asthma, admitted because of a severe attack. What are the priorities for this mom? Challenge the students to come up with a plan for how her children will be cared for while she is in the hospital. Even consider that the mom now insists she is fine – even with a pulse ox of 91% – and is going home. What discharge instructions can you offer the mom?

This type of simulation challenge in class really helps the students see the need for patient-centered care.

Another important way to teach PCC while in lecture is to bring the simulated electronic health record (EHR) into class (e.g. SimChart). This tool is very powerful in that it allows the students to respond to lecture by doing something clinically in the EHR. Create a blank EHR and have two to three students login to one EHR.

Ask the students to complete a focused assessment on a client (e.g. the free case study at the back of a chapter in the textbook). They do this as a team in the EHR. Now, tell the students that the client just found out his spouse suddenly died in a car accident and have the students do another focused assessment on the client. What changed?

Curve balls can also help students develop their PCC muscles. These are called Client-Centered Curve Balls (C3 Balls) and can be any type of change in a scenario that require focus on PCC. For example, the faculty member introduces a client during lecture (maybe the patient at the end of a chapter). The students spend five to 10 minutes working with the patient, then the instructor tosses a C3 Ball. Some examples may include:

  • Your client is now a single parent with two toddlers at home and no one to provide care.
  • The client’s son just called. The client’s wife has died.
  • The client was happy with the plan of care until the husband arrived. Now she is refusing care and demanding to leave against medical advice.
  • The patient is now a 14-year-old.

After a week or two of tossing C3 Balls to students, randomly pick students, and have them CREATE a C3 Ball to offer the class. This really takes the idea of PCC to another level.

Overall, these changes in client scenario challenge the students’ understanding of PCC and help them begin to see reality in the middle of a classroom activity.

Bringing simulation into the classroom and changing patient scenarios are important strategies to help your students begin to build habits that facilitate PCC. Doing these activities a couple times per week will not only improve their growth in the area of PCC but also develop their clinical judgment abilities. Start today.

Tim Bristol,

PhD, RN, CNE, FAAN

For more tips and resources from Tim Bristol, click here.
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