Careful planning is required to educate nursing students at all levels. Much of that planning happens at the curricular level in the development of course, clinical, and assignment objectives or outcomes, all adding up to program outcomes for students. But little undergraduate, prelicensure nursing education literature exists about the actual planning of classroom activities and, more important, the documentation of that planning. In primary and secondary school education (i.e., kindergarten through 12th grade), planning individual classes and activities, known as lesson planning, is so entrenched that most teachers would not think of starting their day without a written lesson plan. They help frame what both teacher and student will do during a specific time period, and learning how to create lesson plans is an important part of kindergarten through 12th grade teacher education (John, 2006). This article explains the potential importance of lesson planning to nursing education as educators increasingly embrace more complex teaching modalities in the classroom.
Three trends in nursing education make careful planning of classroom activities an important addition to the nurse educator's toolkit. First, Millennial students currently come to the classroom with expectations about the classroom experience that include technology integration, active engagement, and experiential learning (Phillips & Trainor, 2014). Building active classroom experiences takes planning, as they involve multiple actors (e.g., teachers, students, student teams), in-class resources, and good time management. Second, the traditional separation in nursing curricula of content teaching and clinical experiences does not necessarily enable the application of content to clinical problems students will encounter in practice. Integration must be deliberate, planned, and threaded throughout the curriculum, requiring teachers to situate content acquisition within the clinical context to help students gain a sense of salience and clinical know how (Benner, Sutphen, Leonard, & Day, 2010). Nurse faculty must be flexible and creative, using clinical concepts as the foundation on which students build knowledge (Tanner & Bellack, 2010). Finally, the profession is facing a wave of retiring teachers (American Association of Colleges of Nursing, 2015). If these educators leave with their classroom activities and strategies undocumented, the profession stands to lose their collective wisdom. Currently, more than ever, it is important for nurse educators to document their classroom lesson plans, if only to be able to leave them behind for those who replace them.
In addition to changes in technology, there has come a change in the way educators think about instruction itself. Most nurse educators learned in classrooms that adhered to the banking model of education, in which students opened their minds and professors poured in knowledge, class preparation for faculty involved updating lecture notes and presentations, and the delivery of lecture formed the plan for the class period. Students did not have much of a role beyond listening, watching, and taking notes. The current classroom is becoming more active for students and teachers, and higher education faculty are being asked to incorporate active learning strategies into the classroom to make the classroom less teacher centered, as is the case with lecturing, and more student centered, as is the case with strategies such as problem-, project-, inquiry-, and case-based learning—all examples of active learning strategies, and all of which encourage learning through carefully crafted experiences rather than static texts and content lectures (Savery, 2006). For nursing education, the need for active learning strategies is even greater because “presenting ordered and classified information does little to prepare students to use knowledge” (Benner et al., 2010, p. 66).
Active learning requires activities on the part of teacher and student, as well as the coordination of resources, space, and time. Many moving parts are included in the active classroom period. Students may split into groups, engage in activities and facilitated dialogue, work on projects, report on their work, or work with technology, such as computers or manikins. Faculty may introduce topics and activities, monitor activities, troubleshoot technology, watch the clock, and generally serve as the conductor of the orchestrated chaos that is the active classroom. For nursing, incorporating active learning strategies in the classroom is particularly important because in a practice discipline, it is vital to situate all learning within the clinical context and to rid education of the sharp delineation made between content and clinical experiences (Benner et al., 2010; Tanner, 2010). Nurse educators are acknowledging that adding more content to programs is unsustainable and are increasingly responding with active learning strategies for which lesson planning is an important tool. Something has to serve as a guide for the active class period. Walking into a 2-hour class period without a roadmap or guide is like asking an actor to go on stage without a script. Lesson plans are the roadmaps for the active learning classroom.
The Lesson Plan
Borrowing from the primary and secondary school toolkit, the lesson plan is a way to prepare for a classroom experience that requires activities for the learners and the teacher. It can serve as a guide during class, a resource for the next person who teaches the course or a substitute teacher, and a historical document for teacher review and accreditation (Jensen, 2001). It gives teachers and students, active participants in the learning experience, a guide to the lesson. Lesson plans help teachers clarify the goals and objectives for the class period, the activities designed to meet those goals and objectives some of which may happen outside of class, the sequence and duration of those activities, and resources required for the class period.
The lesson plan is so fundamental to primary and secondary education that little literature exists on design or on how it emerged as a classroom technology. Critical of lesson plans, John (2006) stated they emerged from the rigid, mechanistic emphasis on planning lessons to meet highly specific objectives with organized teacher activities popularized in the mid-twentieth century in the United States. John (2006) stated that lesson planning in kindergarten through 12th grade education is ubiquitous and templates abound.
One frequently cited source for lesson plan concepts is Madeline Hunter (1982, 2004). Although frequently criticized for being too mechanistic and lacking a research base to support its use (Gibboney, 1987; John, 2006), her lesson plan methodology is currently in widespread use, as evidenced by the number of templates found on the Internet and presentation slides from teaching colleges explaining the model and its application in the classroom.
The Hunter (1982) lesson plan model includes:
- Anticipatory set: Helping students see the relevance of what is to be learned in the lesson.
- Objectives and standards: Student learning outcomes by which learning may or may not be evaluated.
- Teaching and modeling: This may include lecture, discussion, demonstration, or expert video.
- Guided practice: Students practice what they are to learn with the instructor available.
- Check for understanding: May be an examination, discussion, or student demonstration.
- Independent practice: May be group, independent, with supervision, or without supervision.
- Closure: Cues by the teacher that students have mastered what was to be learned.
In nursing education, objectives and outcomes for students are highly prescribed by accrediting bodies, the NCLEX, and individual program objectives that are required by accrediting bodies. Programs deviate from these objectives at their peril, should NCLEX pass rates fall or reaccreditation be at risk. How educators meet these objectives may be prescribed to some extent by educational requirements found in state nurse practice acts, requiring specific amounts of laboratory, clinical, and lecture hours; faculty ratios; and even facilities. However, within these constraints, it is possible to be creative with how educators teach. Although it seems daunting to plan active learning activities for 65 students in a lecture class, it does not mean educators have to resort to lecture. However, they do need to plan for class periods with the same care and effort currently used to evaluate learning.
Lesson plans should reflect the curricular boundaries within which nursing students learn. It is important to incorporate such things as NCLEX Client Needs Categories (NCSBN, 2015), QSEN (QSEN Institute, 2014) competencies and outcomes, the AACN (2008) Essentials outcome statements, among others, as overarching outcome guides. There should be opportunities for students to work in dyads or teams because they will practice in teams after they graduate. The lesson plan is really the end point in the hard work of curriculum development, and it conveys much about one's philosophy of education (Jensen, 2001).
Components of a Lesson Plan Template for Nursing
A simple Internet search on the term lesson plan yields many forms of lesson plan templates available for free or for purchase online. Most are far simpler and less theoretical than Hunter's (1982). The Figure shows a sample lesson plan template for nursing developed by the author, allowing flexibility for incorporating any type of learning activity but still containing elements of education vital to nurse educators, as well as elements of Hunter's (1982) model. The template provides a means of cataloging and mapping the lesson for efficient record keeping, a clear way of listing resources needed (e.g., time, equipment, environment, technology, and people), a place for describing in detail the objectives of the lesson and the activities in which students, faculty, and others will engage along with a time counter, evaluation criteria and methods, and a reference list to help guide updates and revisions.
Lesson plan template. Note. QSEN = Quality and Safety Education for Nurses; BSN = Bachelor of Science in Nursing.
Using the lesson plan in the Figure, the first step in planning is to consider the curricular purpose of the lesson using the program's framework as guide. Each lesson should help students work toward some outcome found in that framework. Situating the lesson in the program framework constitutes Hunter's (1982) anticipatory set in that it highlights the salience of the lesson in the context of becoming a nurse. For this reason, students may benefit from having access to the lesson plan prior to beginning activities.
Using infection control as an example of an early lesson for students in a foundational course, the lesson might map to the QSEN (QSEN Institute, 2014) related outcomes of safety, team-work, and collaboration. A short list of objectives for the lesson might include that students will correctly determine when and how to wash hands (safety), don and discard gloves (safety), and appropriately address lapses in technique with their colleagues when necessary (teamwork and collaboration) during a brief simulated patient care episode. The educator should list all resources, such as videos, texts, research articles, low-fidelity manikins, students role-playing patients, simulated patient care areas, hand hygiene stations, and gloves, among others. For the instructional component (see bulleted points previously listed in this article), the teacher describes each activity for student and teacher, including how students will divide into groups and who will conduct what part of the lesson. These activities should include teaching and modeling, which may happen as preclass activities (e.g., readings and computer programs), guided practice (e.g., case studies and simulated patient care scenarios), checking for understanding (e.g., observing students performing in the care scenarios), and independent practice (e.g., students role-playing patients and nurses). Finally, the lesson ends with a discussion or debrief to achieve closure.
The more information contained in the lesson plan the better, as the plan may be used by a colleague. Each activity is listed in minute-long increments, and the instructor determines the duration of the lesson. Deliverables, or items students will produce for the lesson and hand in, are described, as are evaluation methods for the lesson, with grading criteria and due dates. Finally, references, work sheets, grading rubrics, or other documents to the lesson plan are attached for future reference.
Teaching in the active classroom requires planning, as students and educators all have work to do during a class period. As the conductor of this orchestrated learning, educators should find and use lesson plan templates to help them carefully plan and document activities designed to promote learning and help others (and themselves) follow their tracks. Lesson planning is such an integral part of the kindergarten through 12th grade teacher toolkit yet it has little research to support its use. However, embarking on a journey through active learning with students without a roadmap for that journey is never a good idea because, in the words of Yogi Berra, “If you don't know where you are going, you'll end up someplace else” (Biography, n.d.).
- American Association of Colleges of Nursing. (2008). Essentials of baccalaureate education for professional nursing practice. Retrieved from http://www.aacn.nche.edu/education-resources/essential-series
- American Association of Colleges of Nursing. (2015). Nursing faculty shortage. Retrieved from http://www.aacn.nche.edu/media-relations/fact-sheets/nursing-faculty-shortage
- Benner, P., Sutphen, M., Leonard, V. & Day, L. (2010). Educating nurses: A call for radical transformation. San Francisco, CA: Jossey-Bass.
- Biography. (n.d.). Yogi Berra. Retrieved from http://www.biography.com/people/yogi-berra-9210325#synopsis
- Gibboney, R.A. (1987). A critique of Madeline Hunter's teaching model from Dewey's perspective. Educational Leadership, 44(5), 46–50.
- Hunter, M.C. (1982). Mastery teaching. Thousand Oaks, CA: Corwin Press.
- Hunter, R. (2004). Madeline Hunter's mastery teaching: Increasing instructional effectiveness in elementary and secondary schools. Corwin Press.
- Jensen, L. (2001). Planning lessons. In Celce-Murcia, M. (Ed.), Teaching English as a second or foreign language (403–407). Boston, MA: Heinle & Heinle.
- John, P.D. (2006). Lesson planning and the student teacher: Re-thinking the dominant model. Journal of Curriculum Studies, 38, 483–498. doi:10.1080/00220270500363620 [CrossRef]
- National Council of State Boards of Nursing. (2015). NCLEX-RN Examination: Test plan for the National Council licensure examination for registered nurses. Retrieved from https://www.ncsbn.org/RN_Test_Plan_2016_Final.pdf
- Phillips, C.R. & Trainor, J.E. (2014). Millennial students and the flipped classroom. Retrieved from http://asbbs.org/files/ASBBS2014/PDF/P/Phillips_Trainor(P519-530).pdf
- QSEN Institute. (2014). Competencies. Retrieved from http://qsen.org/competencies/
- Savery, J.R. (2006). Overview of problem-based learning: Definitions and distinctions. Interdisciplinary Journal of Problem-Based Learning, 1(1). Retrieved from http://dx.doi.org/10.7771/1541-5015.1002 doi:10.7771/1541-5015.1002 [CrossRef]
- Tanner, C.A. (2010). From mother duck to mother lode: Clinical education for deep learning. Journal of Nursing Education, 49, 3–4. doi:10.3928/01484834-20091216-01 [CrossRef]
- Tanner, C.A. & Bellack, J.P. (2010). Our faculty for the future. Journal of Nursing Education, 49, 123–125. doi:10.3928/01484834-20100218-01 [CrossRef]