By Gannon Tagher, EdD, MSN, RN, APRN
How many times have you looked out over your classroom and seen students with glazed eyes, or worse looking at Instagram and shopping on their laptop? How often do you think to yourself, “Why aren’t they paying attention? Don’t they know how important this information is?” As nurse educators, we think that our students will need to know all of the information we wish to convey to them about our area of expertise. After all, we’re passionate about it, why aren’t they?
Traditional Lectures vs. Storytelling
I ask you to think about how you are teaching. If you are lecturing to your students, using only PowerPoints filled with bulleted information, why would you expect your students to be engaged? Would you be engaged if you were watching slide after slide about the pathophysiology of heart failure, pharmacologic interventions, assessment, nursing interventions, and evaluation of outcomes? To that I say BORING! And I’m not even a traditional age college student used to snippets of information coming at me from a million different directions.
I have always told my students that I hate to hear myself talk, because if I’m talking so much during class then I’m boring myself. Therefore, I began teaching with a flipped classroom. I know that many nurse educators question how students can learn all of the content needed in a flipped classroom format. My answer is to challenge all nurse educators to rethink why we teach “all of that content”. We are teaching nurse generalists. When they graduate from our programs we want them to be prepared to pass NCLEX and to enter the world of nursing, whatever the specialty they choose. Therefore, we must teach them to think critically and have sound clinical judgement. This cannot be taught through traditional lecture.
One element of a flipped classroom is the use of storytelling. Whether you use stories of real patient situations or make them up, stories engage students. Present the opening of a scenario such as Zac Taylor, a 4-month-old presenting with respiratory distress. Give a social history, including family situation, cultural nuances, or anything else that you would like to bring into the story to make the students think. Think of all of the questions you could ask the students: “What does respiratory distress look like in a 4-month-old?”; “What subjective and objective assessment findings might you see?”; “What assessment findings would warrant immediate intervention?”
From there, as the instructor, progress the scenario however you see fit. How might the patient’s social situation affect the scenario? Give assessment findings and ask the students to prioritize. Once an intervention is decided upon, give outcomes to the students and ask them what they would do next. Take the story in multiple different directions by asking what would you do if B had happened rather than A? The beauty of the story is that it unfolds based on the students’ responses and it will be different every time you teach it. This is what makes it engaging for your students, the story is new for them and it is new for you. Yes, you have to be able to think on your toes.
Implement Storytelling in Small Doses
If this makes you uncomfortable try it in one lecture, and in small doses. For the first half of class give a mini lecture and in the second half of class ask the students to apply the information through storytelling. From there, if it is possible, take the story into the simulation lab and have the students act it out to see if they are able to actually assess the patient and implement the interventions they discussed in class.
I realize that using pedagogy other than traditional lecture can be daunting to many. I would not recommend changing your strategy all at once. As I stated earlier, implement storytelling in small doses to see if it works for you. I also know that many are worried about outcomes with the use of active pedagogy such as storytelling. I traditionally teach pediatrics in the senior year. In my program we use standardized exams throughout the program and the pediatric scores are consistently above the benchmark score. Additionally, I have never had a complaint from students about the format of the class. In fact, quite the opposite. Students often state that they love the interactive classes because it makes them think. Isn’t that ultimately what we are trying to teach our students, how to develop clinical judgement and think like nurses? Give it a try and I promise you will see the power that storytelling can have in nursing education.