This article explores the American Nurses Credentialing Center (ANCC) primary accreditation educational design process (EDP) criteria 5, which addresses how strategies used to promote learning and actively engage learners are incorporated into educational activities (ANCC, 2015). The criteria corresponds with the Association for Nursing Professional Development's Nursing Professional Development: Scope and Standards of Practice standard 5 and 5-B, which focus on learner engagement and positive learning environments (Harper & Maloney, 2016, p. 38). This article provides information for the nurse planner (NP) and nursing professional development (NPD) practitioner to apply when designing and implementing educational activities to promote learning by facilitating learner engagement.
Understanding Promoting Learning with Learner Engagement
As described in the first four articles of this Administrative Angles series, the first step in the educational design process (EDP 1) is identification of the practice gap that is the “distance between where things are now and where they could or should be” (Dickerson & Graebe, 2018, p. 4). The second step (EDP 2) is the identification of the appropriate educational need (knowledge, skill, and practice) that validates the established practice gap (Moyer & Graebe, 2018). The third step (EDP 3) is “identify and resolve all COI for all individuals in a position to control educational content” (ANCC, 2015). The fourth step (EDP 4) requires that activities be designed to “demonstrate how content of the educational activity is developed based on the best available current evidence to foster achievement of desired outcomes” (ANCC, 2015, p. 39). The fifth step (EDP 5) requires that activities be designed and implemented to engage learners in the learning process and promote learning (ANCC, 2015, p. 39).
Continuing nursing education activities are designed to improve the professional practice of nursing and affect health outcomes (ANCC, 2015). EDP 5 focuses on the role of the NP or NPD practitioner to ensure that content is designed to incorporate appropriate teaching methods that promote learner engagement. Learner engagement strategies should be aligned with the identified practice gaps and desired learner outcomes (ANCC, 2015, p. 23). In addition, learner engagement strategies may serve as a measure of formative evaluation of learning outcomes and address the underlying educational needs of the learner by providing the NP or NPD practitioner and presenter with real time feedback.
The Nursing Professional Development: Scope and Standards addresses learner engagement under standard 5: implementation, and standard 5-B: facilitation of positive learning and practice environments (Harper & Maloney, 2016). This standard specifies that the NP or NPD practitioner engages learners, facilitates the education of learners, selects learning strategies to promote a positive learning environment, uses various educational strategies to meet learners needs, and promotes thinking and learning (Harper & Maloney, 2016, p. 38).
Promoting Learning with Engaging Activities
Learner engagement strategies should be developed using the best available evidence from research and the education sector. Researchers have demonstrated that the sole use of lecture is inadequate to engage learners or to promote long term recall (Sousa, 2011). In fact, evidence indicates that optimal learning occurs when participants are actively involved in the learning process. Learner engagement strategies require learners to actively participate in educational activities to meet the desired outcome. Researchers in the field of education have demonstrated effectiveness of several learning activities including simulation (Adamson, 2015; Harder, 2010), concept mapping (Daley, Morgan, & Black, 2016), solving case studies (Forsgren, Christensen, & Hedemalm, 2014), and problem-based learning (Chunta & Katrancha, 2010; Dagyar & Demirel, 2015). Additional strategies can be devised based on extrapolated evidence and based on the creativity and innovation of the NP or NPD practitioner (Pilcher, 2015). Examples of learner engagement strategies activities are listed in the Table. Many of the activities listed in the Table could also be used for web-based learning. Additional online strategies could include virtual scavenger hunts, online field trips, virtual simulations, online journal analysis, virtual assessment activities, discussion forums, wikis, and virtual rounds.
Examples of Learner Engagement Strategies
Applying Learner Engagement Strategies to Promote Learning
Learner engagement is crucial to the learning process given that it increases the probability of the learner to retain knowledge and apply that knowledge into professional practice. The following scenario provides the NP or NPD practitioner with an example of how to incorporate learner engagement strategies to promote learning.
It was determined through quality chart audits and validated in an environmental scan that wound ostomy referrals from the Post Anesthesia Recovery Room (PACU) were low and patients were being admitted to the inpatient floors after boarding in the PACU with early-stage pressure ulcers that were present prior to hospital arrival. The chief nursing officer requested that all nurses in the PACU be educated about pressure wounds. The desired learning outcome was to enhance recognition of early-stage pressure ulcers and would be measured by appropriate wound ostomy referrals within 24 hours of admission. The practice gap identified that only the experienced nurses could recognize early-stage pressure ulcers and that all nurses did not know how to make a patient referral. The underlying educational needs identified are knowledge, skill, and practice. Prereading was required by the nurses who were not able to recognize early-stage pressure ulcers to address the knowledge component. The following strategies were included in the activity implementation by the NP or NPD practitioner to engage learners and promote learning:
- A group concept-mapping activity was used to introduce the topic, examine participant baseline knowledge, and encourage participants to explore key factors influencing nursing care.
- Experienced nurses were included to provide support and enhance teamwork and collaboration.
- Group discussion and question-and-answer sessions were included in the lecture series.
- A matching game was used to examine pressure ulcers.
- Nurses recorded their assessment of photographs with various pressure ulcer stages, and then peer reviewed those assessments. Nurses also worked in groups to analyze and solve case studies related to pressure ulcers.
- Nurses then simulated how to place a patient referral to the wound ostomy department.
- The interprofessional PACU team participated in a reflective activity, “Put yourself in their shoes,” that was used to promote longitudinal learner metacognition regarding patient and family perspectives regarding the disease.
ANCC Primary Accreditation Criteria Implications
EDP 5 requires the provider unit to have an operational process that evidences adherence and compliance with design principles that demonstrate the strategies it uses to promote learning and actively engage learners (ANCC, 2015). As a part of the educational design process, the provider unit must evidence how the NP and the planning committee utilize engagement strategies in educational activity planning to engage learners. It is important to note that lecture and PowerPoint presentations are not considered strategies. Strategies to operationalize engaging learners may include, but are not limited to, opportunities for dialogue and discussion, including time for self-reflection, peer review, analyzing case studies, or problem-based learning (ANCC, 2015). Formative assessment is an employable engagement strategy that NPs and the planning committee can incorporate into activities that challenge the learner to participate and achieve identified learner outcomes.
- Adamson, K. (2015). A systematic review of the literature related to the NLN/Jeffries simulation framework. Nursing Education Perspectives, 36, 281–291. doi:10.5480/15-1655 [CrossRef]
- American Nurses Credentialing Center. (2015). 2015 ANCC primary accreditation provider application manual. Silver Spring, MD: Author.
- Chunta, K.S. & Katrancha, E.D. (2010). Using problem-based learning in staff development: Strategies for teaching registered nurses and new graduate nurses. The Journal of Continuing Education in Nursing, 41, 557–564.
- Dagyar, M. & Demirel, M. (2015). Effects of problem-based learning on academic achievement: A meta-analysis study. Education and Science, 40, 139–174.
- Daley, B.J., Morgan, S. & Black, S.B. (2016). Concept maps in nursing education: A historical literature review and research directions. Journal of Nursing Education, 55, 631–639. doi:10.3928/01484834-20161011-05 [CrossRef]
- Dickerson, P. & Graebe, J. (2018). Analyzing gaps to design educational interventions. The Journal for Continuing Education in Nursing, 49, 4–6. doi:10.3928/00220124-20180102-02 [CrossRef]
- Forsgren, S., Christensen, T. & Hedemalm, A. (2014). Evaluation of the case method in nursing education. Nurse Education in Practice, 14, 164–168. doi:10.1016/j.nepr.2013.08.003 [CrossRef]
- Harder, N. (2010). Use of simulation in teaching and learning in health sciences: A systematic review. Journal of Nursing Education, 49, 23–28. doi:10.3928/01484834-20090828-08 [CrossRef]
- Harper, M. & Maloney, P. (2016). Nursing professional development: Scope and standards of practice. Chicago, IL: Association for Nursing Professional Development.
- Moyer, A. & Graebe, J. (2018). Identifying the underlying educational needs that contribute to the professional practice gap. The Journal for Continuing Education in Nursing, 49, 52–54. doi:10.3928/00220124-20180116-02 [CrossRef]
- Pilcher, J.W. (2015). Balancing innovation and evidence. Journal for Nurses in Professional Development, 31, 100–105. doi:10.1097/NND.0000000000000135 [CrossRef]
- Sousa, D.A. (2011). How the brain learns (4th ed). Thousand Oaks, CA: Corwin.
Examples of Learner Engagement Strategies
|Questions and answers||In order to engage the learner, questioning should go beyond pre- and posttesting strategies, and may include:
Embedded polling and survey questions that participants respond to using clickers, tweeting, or texting.
Open-ended questions for small- or all-group discussion.
Asking participants to finish the story in a case example.
|Games and gaming||Can include puzzles, matching activities, riddles, or modifications of popular game shows or board games.|
|Reflective activities||Strategies to promote reflection can include 1-minute papers or put yourself in their shoes activities, blogging, or journaling.|
|Concept maps||Concept mapping can be used in a variety of ways to engage learners, including pre- and posttesting, brainstorming, or encouraging holistic thinking.|
|Problem solving||Opportunities to solve problems are commonly addressed with case studies and problem-based learning activities but can also include brief activities in which learners analyze blunders or identify what's wrong with this picture.|
|Hands-on activities||Return demonstration, role-playing, simulation, and teach back are commonly used hands-on activities.|
|Creation activities||One of the highest levels of learning occurs when learners use new knowledge or skills to create something. Examples of creation activities include designing a visual, creating a blog, and developing a case study.|
|Flipped classroom format||The flipped classroom format is set up so that learners complete prework, such as reading materials or watching videos (which was included historically during class). Then, the majority of the face-to-face time is spent applying the content.|