Why Not Try TBL to Improve Student Nurses Clinical Reasoning & Communication? Tracy L. Brewer, DNP, RNC-OB, CLC Crystal Hammond, MSN,CNM Deborah Ulrich, PhD, RN Introduction Nursing has long been searching for creative ways to assure students’ abilities to improve clinical reasoning and communication. Strategies to relate didactic content to clinical application has been a challenge for nursing educators. Students entering the clinical site are ill prepared to connect concepts from didactic lecture for clinical application. An immediate need for change in pedagogical strategies was identified. Year Class Taught Number of Students in course Mean Course Grade Mean OB Specialty HESI National Mean OB Specialty HESI Course Changes Winter 2010 97 79 759 833 First time Dr. Brewer and Crystal Hammond taught course together Completion of Evolve case studies was optional Taught traditional lecture format in 10 week quarters Spring 2010 110 80 741 Completion of Evolve case studies became mandatory Winter 2011* 78 83 888 839 Traditional lecture format with added NCLEX type questions during lecture with verbal audience response* Winter 2012 98 895 840 Introduced high & low fidelity simulation to a pilot group of 16 students Conducted a final exam review session Fall A 2012** 44 89 921 867 Converted to semesters with 7 weeks of OB and 7 weeks of PEDS Introduced team-based learning** in the class room No care plans in clinical, but 5 reflective journals related to QSEN competencies. All students attend high/low fidelity simulation Fall B 2012 39 87 912 Spring A 2013 41 88 942 Peer evaluations were added as part of the total grade Spring B 2013 970 The Steps to Success Grading Scale 93.0 –100 = A 84.0 – 92.99 = B 75.0 – 83.99 = C 66.0 – 74.99 = D < 65.99 = F **TBL Started *Interactive Teaching The Steps to Change Commitment and perseverance to change teaching strategy to team-based learning (TBL) despite others saying it could not be done Full support of administration Development of iRATs, gRATS, & applications Selling the TBL strategy to the students through a TBL orientation Doing it! Conclusions Students receptive to TBL stated, “I felt like I really learned how to think like a nurse!” Some students felt there was too much time spent out of class for preparation. There was more resistance to implementation of TBL by faculty colleagues NOT teaching in the course than students who participated in the course using TBL strategies. TBL strategies improved overall course grades, standardized test scores, clinical reasoning, and communication. Further assessment of student learning and performance in the TBL environment is needed. Implementation Nursing students participating in TBL applications Faculty Goal **TBL Started *Interactive Teaching Acknowledgements Dr. Dean Parmelee, Associate Dean of Academic Affairs, Boonshoft School of Medicine Wright State University for his continued mentorship with implementation of team-based learning. NUR 3440 Nursing Students! Each team decided on a team name based on OB concepts