The 2016 NCLEX-RN Test Plan includes 15% pharmacological and parenteral therapies (National Council of State Boards of Nursing, 2016). Integrating pharmacology into the curriculum of the authors' southeastern U.S. Associate Degree of Nursing program has been an ongoing challenge. Students can be overwhelmed by the amount of medication concepts and content they are required to learn. Nurse educators have reported use of innovative methods of teaching pharmacology, such as visualizing medications in related rooms in a house (Montenery, 2013) and by using homemade cookies to review medication administration and pharmacokinetics (Quinn, 2016). Knowles (1984) believed that adults learn better when they can immediately apply new knowledge. Faculty of this 2-year program wanted to present a relevant pharmacology learning opportunity to the 32 second-semester students that could be completed in a class period and therefore decided to develop a content learning activity using the engaging Kahoot!© student response system ( http://getkahoot.com).
Kahoot! is a free online educational learning platform that provides game templates for sets of multiple choice questions. Participants use cell phones or other personal devices to answer questions projected onscreen at the front of the room playing individually or as teams, depending on how the game is set up. As each item is presented, the program provides stimulating music and colorful animated shapes to keep participants engaged in the activity. A timer for each question creates mild competition during the game. Bar graph displays of how many participants chose each of the possible answers provides immediate feedback for class discussion and faculty instruction.
Students were assigned to complete interactive learning tutorials for five medications in the Assessment Technologies Institute (ATI) immune system pharmacology module prior to the laboratory class and asked to bring their ATI pharmacology books and drug guide texts. At the beginning of class, students were instructed to gather in their clinical groups. They were given 1 hour to develop one NCLEX-style multiple choice question addressing nursing knowledge for each of the five assigned medications. Students were allowed to use ATI books and their drug guides to create the test items. Then, faculty members compiled the student-designed questions for review at the end of class. Students were also told that faculty members might use at least one of these questions on the end-of-course pharmacology quiz.
Students were asked to submit their questions with highlighted correct answers to the instructors as soon they finished each item. One instructor reviewed the items for quality, and another entered 10 of them into the Kahoot! quiz template. At the end of the 60-minute period, students took a short break. Upon returning for the last part of the class, the students were surprised to see the colorful, musical, and inviting Kahoot! program projected on the front screen. The faculty had allowed 15 minutes for students to answer the 10 questions with their individual cell phones or devices; results of answer tallies were immediately available on the screen. When the timer expired for each question, faculty facilitated brief discussions of rationales for correct answers. All 10 questions were covered before the end of the class time. After class, faculty posted the 10 questions in the course online platform for students to review in preparation for their graded pharmacology quiz.
Evaluations of the activity were overwhelmingly positive. Students reported that generating questions was helpful for learning about medications, saying it “allowed us to critically think about all aspects of care with patients on these drugs.” Students also enjoyed the competitive and entertaining features of the game and commented that it was fun, interesting, and stress-free learning. There were a number of requests to repeat the activity, and some students suggested adding time for more questions. In addition, all of the students in the class were successful in passing the end-of-course 10-question medication pharmacology quiz, which included the five medications covered in the activity.
Faculty learned during this activity that the Kahoot! item stem allows for only 95 characters, so most student-generated questions needed to be edited before entry into the program template. Another challenge was that the students were not told ahead of time that they would need to bring their phones, and two students had to share devices. For future use, students will be instructed to bring their electronic devices to class and to limit their question stems to approximately 15 words.
Learning pharmacology has been a continuing challenge for Associate Degree Nursing students. Use of student-created pharmacology questions, compiled into an interactive Kahoot! quiz game, was an enjoyable learning experience for 32 second-semester students; all students also successfully completed an end-of-course pharmacology quiz. The faculty plans to use this combination of learning strategies for future classes.
Susan G. Bryant, MSN, RN, CNE, CHSE
Jennifer M. Correll, MSN, RN, CDE
Brandy M. Clarke, MSN, RN, CNE
Davidson County Community College,
- Knowles, M. (1984). The adult learner: A neglected species (3rd ed.). Houston, TX: Gulf.
- Montenery, S. (2013). Reinforcing pharmacology content using the medication mansion. Nurse Educator, 38, 96–97. doi:10.1097/NNE.0b013e31828dc198 [CrossRef]
- National Council of State Boards of Nursing. (2016). NCLEX-RN test plan. Retrieved from https://www.ncsbn.org/testplans.htm#8452
- Quinn, B. (2016). Engaging nursing students in an edible pharmacological lesion: Cookies in the curriculum. Nurse Educator, 41, 286–287. doi:10.1097/NNE.0000000000000302 [CrossRef]