Improving the outcomes of patients experiencing an impending MI by preparing nursing students to recognize the important findings in these patients, interact therapeutically with the patient, and initiate treatments in a timely manner was the focus of the DNP project.

Background

  While traditional lecture methods dominate most nursing school classrooms, it does not usually provide an avenue for active learning and yet, many students repeatedly explain that they “learn best by doing”. According to Kane (2004), active learning may be described as a theory, but it is also associated with implementing teaching methodologies that provide numerous examples of activities that educators can use in different learning environments. In considering clinical practice opportunities, many nursing students may not have the occurrence to care for a patient experiencing an impending MI. A need for change in teaching methods is recognized.

  In the past several years, simulation has gained much popularity in nursing education and review of literature reveals much discussion on the topic. The literature gives account of the evolution of simulation activities and their impact on bridging theory with practice. This is readily evidenced by reviewing how flight simulators have improved aviation and space program activities. In healthcare, the development of Resusci-Anne began the movement towards simulation activities as a plausible way of teaching. Within medical-education, simulation-based learning has been found to be superior for acquiring critical assessment and management skills, (Steadman, Coates, Huang, Matevosian, Larman, McCullough and Ariel, 2006). In an effort to assist students in learning and thereby, better improve their ability to impact patient outcomes, a change in teaching methods was undertaken.

Quality Improvement

  Newhouse, Pettit, Poe, and Rocco (2006) describe quality improvement projects as means to understand and improve processes, where individuals work together to improve outcomes, in order to benefit individuals served by the organization. Roueche, Baker, and Rose (1989) stress the importance of an organization knowing “what business it is in” and conclude that community colleges should, among other qualities, build relationships with learners, and be adaptable to new conditions or circumstances, with ever awareness of its community. The DNP student’s project was likened to a “microsystem in health care”, described by Godfrey, Nelson, Wasson, Mohr, and Batalden (2003) where a small functional unit became the focus for improvement. The system was called upon by the project’s focus to remember what business it’s in, accommodate diverse learning needs of students, and increase success for the student and program as a whole, and impact patient outcomes.

  Duke University Medical Center (2005) presented The FADE Model, a method of quality improvement (QI), which provided the approach used to assess the present system targeted for change, and implement the proposed plan for change. The four steps of the FADE QI model include: 1) focus, 2) analyze, 3) develop, and 4) execute and evaluate.

EBP Model

  The Iowa Model of Evidenced-Based Practice to Promote Quality Care provided the standard framework for the DNP project while the Nursing Education Simulation Framework allowed the best practices to become executable processes within the chosen system. The Iowa Model of Evidence-Based Practice to Promote Quality Care was chosen as the research model for the project as Titler (2007) reports that this model approaches evidence based practice from an organizational perspective rather than from the perspective of an individual provider. The Nursing Education Simulation Framework was developed and tested for the National League for Nursing/Laerdal Simulation Study (Jefferies, 2005) and has five conceptual components which include 1) teacher factors, 2) student factors, 3) educational practices that need to be incorporated into the instruction, 4) simulation design characteristics, and 5) expected student outcomes.

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