Using Story to Develop Reflective Practitioners: QSEN Competencies in Action UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL SCHOOL OF NURSING: GWEN SHERWOOD CAROL DURHAM SYNENSYS INC: STEVE POWELL

Objectives Examine story as pedagogy to transform practitioners in integration of QSEN competencies Demonstrate models of story application in education and practice to improve communication

What do you see? –How can I approach situations without preconceived assumptions? Using Story to see beyond the obvious

The compelling nature of Story Powerful change agent ties actions and outcomes See the personal domain in health care Story: Experiential learning theory Apply knowledge and experience to real life situations—situated context Narrative pedagogy

Reflective Practice: Mindful Learning Engage: mindful attentive presence Question: consider cues, assumptions, what you know Interpret: knowledge, questions assumptions, values and beliefs Analyze: reflect on what happened in relation to self, others and context

Integrating QSEN competencies Seek evidence based instructional strategies Address challenge of changing mindset for safety and quality Move from content based instruction to experiential learning to apply KSAs in real world situations what we need to know what we need to do what attitudes guide actions

Analyze situated context of work events Story link: Use 1- 2-All Reflect for one minute on the story Spend one minute sharing with someone near you Discuss major points with all

Reflecting on Story: Deep learning What stands out in this story? What concerns you? Why do you say that? What else could it be? Why? What do you already know that helps in this situation?

Learning experiences based on knowledge acquisition are insufficient to develop competencies Work in small groups to examine one QSEN competency Patient centered care Informatics Quality Improvement Evidence-based practice Teamwork and Collaboration Safety RWJF funded

Consider assessment strategies Use Story with simulation Foster clinical judgment Develop reflective practitioners Story 105:

Clinical Judgment: Developing critical analysis Noticing: Begins with a perceptual grasp of the situation Interpreting: Developing sufficient understanding to respond Responding: Deciding on what to do appropriate to the situation Reflecting: Attending to the patient’s responses while caring for them and assessing the outcomes afterwards. Tanner, 2006

One minute reflections What is the most important skill I learned today? What threats to patient safety did I observe? How well did my values match my practice experiences today? Did I have the opportunity to speak up today?

Reflective Practice: using story Building Emotional Intelligence (EQ) Consciousness of self Consciousness of context Consciousness of others Reflection: surface contradictions and make sense of the complexities of nursing

We all have stories. Cultivate the habit to hear the voices around you Creating your own stories Listen to the voices around you: what are they saying? Reflect on a critical incident to create a case Be brief! Base on human factors versus clinical

Close session: One minute reflections What is the most important skill I learned today? What threats to patient safety did I identify? What values conflicts surfaced today? What opportunities did I have to speak up today? Can also use as assessment reflections