1. Seeing through the eyes of the beholder An innovative approach to learning through reflection in graduate nursing education Geraldine Fahy Marrocco Ed.D. APRN, CNS, ANP-BC YALE UNIVERSITY SCHOOL OF NURSING

2. THE IDEA? How are we perceived by others? We know what we say, but do we ever view ourselves from the point of another? If we see ourselves from someone’s perspective, would we learn anything, change anything? Is there a value in education for a student to have an experience ?

3. The patient interview

4. Specific Aim To determine whether graduate nursing students’ participation in a reflective practice clinical exercise using video taped interviews made a difference in self reflection, insight and reflective thinking about clinical practice competency and interview skills

5. Theoretical Underpinnings Thomas Dewey 1920 Mezirow 1950 Cranton 1980’s Brookfield 1980’s

6. ConstructivenessTheory Using meaning in critical reflection to develop and discover new dimensions from emerging knowledge Critical reflection is paramount to develop new perspectives and to link previously held assumptions

7. Background Limited research studies on educational activities using technology and constructiveness theory Nurse Practitioner must rely on information derived from the patient interview and synthesize the data to arrive at an assessment There is little chance to view one’s self from the patient’s perspective Using a post hoc review of one’s self could lend to a deeper meaning and learning

8. Method Pilot group of 10 students (convenience sample) in their core course in Advance Health Assessment Exercise conducted outside the course, no grade Using pre test and post test design to answer 4 open ended questions Standardized patients met with each student in a mock examining room and conducted the basic interview and review of systems. Each patient held on to a “secret” waiting to be explored Standardized patients wore the Google Glasses

9. The Google Glass Device

11. Procedure 15 minutes allotted for each interview Each Standardized Patient was outfitted with google glasses Students were introduced to each patient to conduct an initial interview Once completed, students were escorted to a private room to write the reflection, by answering 4 open ended questions Students were then escorted to another private room to view the video tape of themselves from the patient’s perspective Once completed, the student was escorted to another room to answer the same 4 open ended questions once more

14. Content Analysis Each set of responses were read in totality to gain a sense of the impact of view the video tape Transcribed interview data were analyzed by identifying key statements to determine if the student perceived a change in the way they thought about and/or reflected on their interview skill

15. Results Perceptions before: Students thought their interviews were: Timely, succinct, and thorough Asked appropriate questions, employing active listening techniques Overall believed they could have covered more aspects of the health history, but were satisfied

16. After watching the video Several additional comments Several areas of new concerns related to verbal and non verbal interview techniques “ I used so many closed ended questions” “ I asked many leading questions, and failed to follow up on patient cues, could have asked more probing questions.” Many felt they had poor body language, lack of eye contact, or excessive facial expressions.

17. After the video Many gaps in in the information Loss of information needed for adequate follow up and decision making Actually missed many elements of the health history, ie. Drinking and smoking history, family history and genetics Overall, students thought the exercise helped them refine their interview language, body habits, and other skills.

18. Discussion & Conclusions Using technology to enhance NP education is supported by the AACN ( 2015) A safe and effective approach to learning that has a deeper meaning for each student Expands a student’s prior assumptions Innovative and Sustainable

20. References American Association of Colleges of Nursing, (2015). Current state of APRN clinical education (White Paper). Retrieved April 4, 2015 from http://www.aacn.nche.edu/APRN- WhitePaper.pdf Barr, A. (2015). Google Glass Gets a New Direction. Wall Street Journal. Retrieved March 30, 2015, from http://www.wsj.com/articles/google-makes-changes-to-its-glass-project- 1421343901 Casey, M. (2014). A Google Glass fit for the factory floor - Fortune. Fortune. Retrieved March 30, 2015, from http://fortune.com/2014/09/11/lenovo-vuzix-m100-smart-glasses-china/ Cranton, P. (2000). Individual differences and transformative learning. In J. Mezirow, & Associates (Eds.), Learning as transformation: Critical perspectives on a theory in progress (pp. 181-204). San Francisco, CA: Jossey-Bass Publishers. Dewey, J. (1952). Experience and education. New York: The Macmillan Company. Matuservich, M.N. (1995). School reform: What role can technology play in a constructivist setting. Retrieved from March 3, 2007, from http://pixel.cs.vt.edu/edu/fis/techcons.html Mezirow, J. (1996). Contemporary paradigms of learning. Adult Education Quarterly, 46, 158- 172. doi:10.1177/074171369604600303 Mezirow, J. (1998). On critical reflection. Adult Education Quarterly, 48, 185-198. doi:10.1177/074171369804800305 Mlot, S. (2014). Sony to Show Off Clip-On Smart Glasses at CES. PCMag.com. Retrieved March 30, 2015, from http://www.pcmag.com/article2/0,2817,2473781,00.asp Olsson, M.I., Heinrich, M.J., Kelly, D., Lapetina, J. (2011). United States Patent No. 0130044042. Washington, DC: U.S. Patent and Trademark Office.