Transformative change takes time and poses challenges in devising learning activities to engage students when preparing them to provide safe and effective nursing care in the progression from nursing student to graduate nurse. Educational research has acknowledged a positive relationship between student engagement and student outcomes. To improve student success and retention, higher education recommends the use of high-impact educational practices in teaching (Association of American Colleges & Universities, n.d.). High-impact practices are identified as activities benefiting students who engage in learning experiences that have purposeful tasks, integrative learning, and extend beyond the classroom (National Survey of Student Engagement, 2018). Students learn by doing in the context of real-world experiences (Kuh, 2008).
The American Association of Colleges of Nursing (AACN), in partnership with Apple®, invited a group of nurse educators to attend a 3-day intensive program designed to immerse the participants in digital technology. With the goal of creating and applying content for student engagement, educators were asked to design a digital innovation teaching project that promoted creativity and demonstrated student learning, as well as encouraging critical thinking, collaboration, and communication. This article describes an innovative teaching strategy in which the Apple Clips app was used by nursing students to collaboratively develop videos depicting difficult scenarios faced in nursing leadership as they transitioned from nursing students to graduate nurses. At the end of the project, students were asked to complete a survey on the effectiveness of the teaching strategy as a replacement for a traditional oral presentation in a nursing leadership course.
Educators must compete with a variety of digital devices and social media platforms for the attention of students. In the 10 years since Benner et al. (2010) challenged nurse educators to evaluate teaching pedagogies and develop active learning strategies to improve student engagement, academic nurse educators have made strides to keep pace with the technology explosion designed to enhance the educational process. The original call for transforming nursing education identified Millennials as the primary focus (Benner et al., 2010), but now the landscape has evolved to encompass a new group of learners, Generation Z (Gen Zers). Although multiple generations populate the college classroom, Gen Zers (those born between 1995 and 2012) are now the dominant generation entering college and represent the nurses of the future (Stillman & Stillman, 2017).
Born the same year as the Internet, this generation has been profoundly impacted by advances in technology and are considered true digital natives. Gen Zers adapt constantly to changing technology but express concern over a perceived generational gap regarding the adoption of technology in their education (Stillman & Stillman, 2017; Williams, 2019). They prefer content from accessible technology instead of books and read less than 30 minutes per day (Seemiller & Grace, 2017). Market researchers report that Gen Zers have an attention span of 8 seconds, which provides insight into the challenges for student engagement (Sparks & Honey, 2015).
To engage both Gen Zers and Millennials, nursing faculty are tasked with providing an assortment of unique and innovative teaching strategies across a variety of learning platforms (Williams, 2019). According to the AACN's (2019) Vision for Academic Nursing, virtually every aspect of educating nurses for the future is changing higher education, learners, faculty availability and mix, learning technologies, and health care systems. Faculty shortages and increasing workloads affect the acquisition of knowledge and the application of new technologies used in nursing education.
AACN-Apple Boot Camp
Motivated by the strategic goal “to be at the forefront of setting in motion innovation and excellence in academic nursing” (AACN, 2018, p. 1), AACN and Apple formed a collaborative partnership to host the inaugural Digital Innovation Bootcamp: From Concept to Action. The goal of the boot camp was to provide nurse educators with a “unique opportunity to apply learning theories and education models to develop engaging and inspiring digital content for students” (AACN, 2018, p. 1). A diverse group of nursing educators representing all levels of higher education from across the country was invited to attend. Conducted by Apple development executives and designated Apple distinguished educators, a vivid representation of the current state of technology in education was presented. The impact of technology and the expectations of future students was a startling reminder of the growing impetus to transform the academic setting.
As computers have given way to handheld devices, such as smartphones, tablets, and digital watches, the development of application (app) technology has skyrocketed. Apps are used for myriad reasons; app technology is making a significant impact on health care, and utilization in educational settings should reflect this trend. Recognizing the impact of app technology, the Apple Clips video app was selected for the digital innovation project developed through the AACN-Apple Bootcamp. The app possessed many of the features used by students on social media platforms, was relatively easy to use, and could be downloaded for free. Developed to capture video clips that can be shared, the app allows graphics and live titles in addition to music to be placed in the video. Videos can be developed quickly (Phelan, 2017). To further support the use of app technology for this assignment, one of the largest health care systems recruiting new graduate nurses from this program uses mobile app technology on Apple products to engage patients during hospitalization and after discharge.
Innovation in Teaching: A Digital Project
The course selected for the digital project was the Capstone Nursing Leadership course in a baccalaureate program offered during the final semester prior to graduation. The university dictates general education requirements for all Capstone courses, including extensive oral and written requirements for graduation to be met through class assignments. In the selected course, students were required to give a minimum of two oral presentations; the digital assignment replaced the second oral presentation. Course evaluations identified that students were not satisfied with the current traditional speech assignments. Prior to beginning the digital project and collecting data, Institutional Review Board approval was obtained.
To conduct the digital innovation project, two key elements needed to be assessed prior to writing the assignment guidelines. The first was student access to an iOS device (iPhone or iPad) to use the app technology; a poll of students indicated a significant number had access to an iOS device. A second key assessment factor was what aspects of leadership would influence the students most significantly in developing skills for transition to practice. That answer was revealed in a discussion board question that asked: “What is your greatest concern in transitioning from a nursing student to a new gradate nurse?” Responses were diverse; however, a reoccurring theme was development of communication skills and confronting issues in dealing with physicians, patients, families, and coworkers. Students expressed concern regarding how to manage situations they had never experienced or had experienced only with guidance from an instructor.
In place of a traditional speech assignment, students were required to develop a video using the Clips app. The purpose of this assignment was to develop knowledge and skills in dealing with difficult situations that frequently occur in the clinical or work setting. Students self-selected into teams of five to six members. Topics were chosen by the team with the approval of the course instructor. The group assignment required the teams to develop a scenario depicting a difficult situation or dilemma in nursing. To give the scenario structure, the SBAR (situation, background, assessment, recommendation) tool was used for the format of the video. Students were required to research best practices in managing the situation, role-play the situation, then role-play correct option(s) for resolution of the issue, and indicate the influence of leadership. The videos were limited in length to 5 minutes and were posted to the course Canvas drop box for students to review and discuss in class.
A tutorial for use of the Clips app was provided on the course Canvas site, as well as a video developed by a prior class. Students also were given online links that provided information on dealing with difficult situations and tips on structuring the conversations in the role-play. Topics selected by the students included: bullying and incivility, impaired employees, delegation issues, xenophobia patient negligence, theft in the workplace, and sexual harassment. Viewing each team's finished product in class yielded a rich discussion.
Results and Student Responses
At the conclusion of the digital assignment, student input was pivotal in establishing the effectiveness of using technology and determining the level of student satisfaction with the assignment. After the presentations, 46 of 70 students completed informed consent forms to participate in the survey, which consisted of eight Likert-type questions and five narrative questions. The Clips assignment was a graded assignment; therefore, a faculty member with no connection to the leadership class collected and maintained the required documents until final grades were submitted for the semester.
More than 95% of the student respondents agreed the assignment was an innovative way to learn nursing leadership content and allowed students to be creative, which they had not been able to accomplish in other nursing courses. In addition, 95% of respondents indicated the assignment was more effective in delivering leadership content than a conventional speech, and 93% of respondents acknowledged that by developing and role-playing the difficult situation scenarios, they were able to think about how they would handle a similar situation in the workplace. Students were more neutral on the use of app technology when entering the workforce. Two areas that students identified as less effective were the ease of use of the Clips app and instructions for the assignment. Overall, 100% of the students agreed or were neutral in recommending that the Clips assignment continue to be used in the leadership class as an oral presentation. The results of the questionnaire are summarized in Table 1.
Student Evaluation of Clips Assignment
Results from open-ended questions yielded additional information regarding the assignment. Of the 46 students who responded, 45 students indicated they had access to an iOS (Apple) device. The time required to complete the assignment averaged 2.5 hours (range, 45 minutes to 6 hours). The reoccurring themes of what the participants liked best about the assignment were the ability to be creative while learning, the opportunity to work in teams, working in a relaxed atmosphere, and having fun during the process. Student comments were revealing as to their level of engagement and interest. One student said, “We could be creative and actually do something fun and learn [at the same time].” Another student noted, “When presenting and listening to the presentations, it was more enjoyable, and I actually listened to the presentations.”
Responses to improve the assignment indicated that learning to use the Clips app took some time, and students indicated they preferred a hands-on tutorial rather than a video tutorial. Timing of the assignment also was a concern. Students indicated that they preferred the assignment be due earlier in the semester because the end of semester was a busy time as they prepared for graduation.
Students were able to successfully meet the learning outcomes of the assignment in a creative and innovative manner, and responded in support of a less conventional method of delivering an oral presentation. With overwhelming positive feedback and student satisfaction, the Clips video assignment will become a permanent part of the course, taking into consideration the changes suggested. Other app options are available for making videos; therefore, an adaptation of the assignment will allow students to select from a list of approved apps. Student input also provided critical information for improving the assignment and indicated acceptance of a unique strategy for learning in nursing. The responses also were reflective of their status as Gen Zers, who prefer storytelling to reading and communicating in short clips rather than long conversations. Gen Zers learn by solving real-world problems through observation and practice (Williams, 2019).
The digital assignment was born out of an opportunity to bridge a gap between tradition and innovation. It represented a high-impact educational learning strategy in a collaborative assignment that addressed several components of the BSN Essentials, including communication, teamwork, critical thinking, and problem solving, as well as integration of technology (AACN, 2008). Students learn in many ways, but they learn best when they can relate to the goal of the assignment. Technology for this generation of learners is a way of life. As nurse educators, finding unique and innovative learning opportunities is a necessity for student engagement and meaningful learning experiences.
- American Association of Colleges of Nursing. (2008). The essentials of baccalaureate education for professional nursing practice. http://www.aacnnursing.org/portals/42/publications/baccessentials08.pdf
- American Association of Colleges of Nursing. (2018, June4). AACN announces selection of nursing faculty for digital innovation bootcamp (press release). https://www.aacnnursing.org/News-Information/Press-Releases/View/ArticleId/21537/Digital-Innovation-Faculty
- American Association of Colleges of Nursing. (2019). AACN's vision for academic nursing white paper. https://www.aacnnursing.org/News-Information/Position-Statements-White-Papers/Vision-for-Nursing-Education
- Association of American Colleges & Universities. (n.d.). High impact practices. https://www.aacu.org/resources/high-impact-practices
- Benner, P., Sutphen, M., Leonard, V. & Day, L. (2010). Educating nurses: A call for radical transformation. San Francisco, CA: Jossey-Bass.
- Kuh, G.D. (2008). High-impact educational practices: What they are, who has access to them, and why they matter. https://provost.tufts.edu/celt/files/High-Impact-Ed-Practices1.pdf
- National Survey of Student Engagement. (2018). NSSE 2018 high-impact practices. http://nsse.indiana.edu/2018_Institutional_Report/pdf/NSSE18%20High-Impact%20Practices%20(NSSEville%20State).pdf
- Phelan, D. (2017). Apple Clips, the coolest, most fun thing Apple has done in a long while. Retrieved from https://www.forbes.com/sites/david-phelan/2017/04/06/clips-the-most-fun-thing-apple-has-done-in-a-long-while-first-review/#2f14f0dec545
- Seemiller, C. & Grace, M. (2017). Generation Z: Educating and engaging the next generation of students. About Campus, 22(3), 21–26 doi:10.1002/abc.21293 [CrossRef]
- Sparks and Honey. (2015). Generation Z 2025: The final generation. https://www.sparksandhoney.com/reports-list/2018/10/5/generation-z-2025-the-final-generation
- Stillman, K. & Stillman, J. (2017). Gen Z @ work: How the next generation is transforming the workplace. New York, NY: HarperBusiness.
- Williams, C.A. (2019). Nurse educators meet your new students: Generation Z. Nurse Educator, 44(2), 59–60.
Student Evaluation of Clips Assignment
|Statement||Strongly Disagree/Disagree (%)||Neutral (%)||Strongly Agree/Agree (%)|
|Using Clips was an innovative way to learn nursing leadership content||0||4.35||95.61|
|Clips was easy to use||0||21.74||71.74|
|The tutorial and class instructions for Clips were helpful||36.96||28.26||34.79|
|Using Clips for the assignment allowed me to use creativity that I had not been able to accomplish in other nursing courses||0||4.35||95.95|
|Developing and role-playing the Clips scenario allowed me to think about how I would handle a similar situation in the workplace||0||4.35||93.48|
|The Clips assignment was more effective in presenting the leadership content than a traditional speech||4.34||0||95.65|
|Using app technology will help me when I enter the workforce as a new graduate nurse||12.81||21.74||67.40|
|I would recommend the Clips assignment continue to be used in the nursing leadership course as an oral presentation||0||6.52||93.48|