NR 535 Week 2 Learning Objectives Set Example

Learning Objectives Set: Eight Objectives for Teaching Chest Drainage to First-Year Nurses, Each With an Audience Fixed Before the Verb, an Action Someone Can Watch and a Limit Set by the Ninety Minutes Available

Student Name

College of Nursing, Chamberlain University

NR 535: Theoretical Foundations and Instructional Strategies for the Nurse Educator

Instructor Name

Month Day, Year

Learning Objectives Set: Eight Objectives for Teaching Chest Drainage to First-Year Nurses, Each With an Audience Fixed Before the Verb, an Action Someone Can Watch and a Limit Set by the Ninety Minutes Available

Purpose and Audience

These objectives are for a 90-minute session on chest drainage systems for new graduate nurses in the first three months of our nurse residency program, who work on the unit's twenty-eight thoracic and pulmonary beds. The audience is fixed first, because the right verb depends on who is learning. These nurses have passed a licensing examination and cared for patients with chest tubes as students, usually as observers. They know the vocabulary but have rarely been responsible for the system. They are at the stage Benner (1982) called advanced beginner, able to recognize recurring features of situations with guidance but not yet to see the whole picture unaided.

The session is one of twelve in the residency's first quarter and cannot hold everything about chest drainage. The objectives below are limited to what a new nurse must do safely in the first weeks of caring for these patients alone, and what can be taught and checked in 90 minutes with one drainage system, one task trainer and eight learners.

Rules for Writing the Objectives

Each objective follows three rules. First, the audience is the new graduate nurse, and the objective states what that nurse will do, not what the educator will cover. Second, the verb names an action someone can watch or hear. Verbs such as understand, know, appreciate and be aware of are excluded, because they promise nothing observable. The revised taxonomy of educational objectives distinguishes levels of cognitive process, from remembering and understanding through applying, analyzing, evaluating and creating (Anderson & Krathwohl, 2001), and the verbs below were chosen to match the level the nurse needs to reach, not the highest level that sounds impressive. Third, each objective must be achievable and checkable within the session.

Eight Objectives

When the session closes, each new graduate nurse will be able to:

1. Identify, on a three-chamber drainage system at the bedside, the collection chamber, the water seal chamber and the suction control mechanism, pointing to each and stating its purpose in one sentence. (Remember)

2. Demonstrate, on a task trainer, how to check the water seal for tidaling and for bubbling, and state what each finding means for a patient on water seal and for a patient on suction. (Apply)

3. Distinguish, given three drainage system photographs and brief patient histories, between expected intermittent bubbling, a continuous air leak and a leak in the tubing or connections. (Analyze)

4. Demonstrate the sequence for locating the source of a continuous air leak by briefly clamping along the tubing, stating when clamping is and is not appropriate. (Apply)

5. Record drainage volume and character correctly from the collection chamber, including marking the level and time, for a system with 140 mL of serosanguineous drainage over four hours. (Apply)

6. State the drainage volume and character that require immediate notification of the surgical team under unit policy, and give one example of each. (Remember and understand)

7. Demonstrate the immediate response to accidental disconnection of the tubing from the drainage system and to accidental dislodgement of the chest tube from the patient, on the task trainer. (Apply)

8. Explain, in their own words to a partner, why the drainage system must be kept below the level of the chest and why routine clamping during transport is avoided. (Understand)

What Was Left Out, and Why

Several topics were excluded because they do not fit a first-quarter session or cannot be checked in 90 minutes. Assisting with chest tube insertion and removal is taught later, when residents have spent time with thoracic patients. Digital drainage systems, used only in the operating suite at our hospital, are omitted. Physiology of the pleural space is reviewed briefly in a pre-reading rather than taught, because the objectives concern what nurses do at the bedside and a review of chest drain management for nurses focuses on the practical checks and troubleshooting that prevent harm (Durai et al., 2010).

The set also avoids objectives at the evaluate and create levels. It would be easy to add one, such as design a plan of care for a patient with a persistent air leak, but new graduates at this stage cannot yet do this reliably, and an objective that cannot be met in the session only gives a false sense of rigor.

How Each Objective Will Be Checked

Every objective has a check within the session. Objectives 1, 2, 4 and 7 are checked at the task trainer, with the educator watching each nurse perform the action. Objective 3 is checked with a short photograph exercise, with each nurse writing an answer before discussion. Objective 5 is checked with a documentation exercise on a paper flow sheet. Objective 6 is checked by asking each nurse to state the thresholds without notes. Objective 8 is checked by listening to explanations between partners and asking one follow-up question of each pair.

Objectives that cannot be checked in the session are not objectives for the session. Writing the checks alongside the objectives, rather than after the session is designed, is the test that the verbs are observable: if the educator cannot describe what would be watched or heard, the verb needs to change.

Alignment With Later Sessions

The objectives build toward the residency's later outcomes. In the second quarter, residents will care independently for postoperative thoracic patients, and their preceptors will use a checklist based on these objectives to confirm competence during the first two weeks. In the fourth quarter, residents will attend a session on complex drainage problems, including persistent air leaks and subcutaneous emphysema, which will use analysis and evaluation objectives built on this foundation. Preceptors were asked to review the draft objectives before the session, and two changes came from them: objective 7 was added after a preceptor described a new nurse who froze when a tube separated during a bed change, and objective 5 was made specific because documentation errors on drainage volume were the most common finding in the unit's chart audits. The set is therefore the first step in a sequence, and it is limited on purpose so that each later step has something solid to stand on.

References

Anderson, L. W., & Krathwohl, D. R. (Eds.). (2001). A taxonomy for learning, teaching, and assessing: A revision of Bloom's taxonomy of educational objectives. Longman.

Benner, P. (1982). From novice to expert. American Journal of Nursing, 82(3), 402-407. https://doi.org/10.1097/00000446-198282030-00004

Durai, R., Hoque, H., & Davies, T. W. (2010). Managing a chest tube and drainage system. AORN Journal, 91(2), 275-283. https://doi.org/10.1016/j.aorn.2009.09.026