NR 622 Week 3 Materials Package Example

Teaching Materials Package: Facilitator Guide, Stand-Alone Learner Handout, Nine Scenarios With Their Key and an Editable File Set for the Heparin Titration Practice

Student Name

College of Nursing, Chamberlain University

NR 622: Nurse Educator Concluding Graduate Experience II

Instructor Name

Month Day, Year

Teaching Materials Package: Facilitator Guide, Stand-Alone Learner Handout, Nine Scenarios With Their Key and an Editable File Set for the Heparin Titration Practice

Contents

1. Facilitator guide, version 1.2, 2 pages.

2. Learner handout and job aid, version 1.1, 1 page, two-sided.

3. Scenario set A, version 1.2, 9 scenarios on 3 pages.

4. Scenario set B, version 1.0, 9 scenarios on 3 pages, matched in difficulty to set A.

5. Answer keys for sets A and B, version 1.2 and 1.0, 2 pages, reviewed by the pharmacy informatics pharmacist.

6. Eight-step observation checklist, version 1.0, 1 page.

7. Preceptor sheet, version 1.0, 1 page.

All files are in the unit shared drive, Education folder, Heparin practice subfolder, in editable word-processing format with a PDF copy.

1. Facilitator Guide: Wording for the Moments That Go Wrong

The guide does not repeat the whole session; the run sheet does that. It gives exact sentences for the three moments where sessions on this skill usually stall.

Moment 1, a boundary result. When an anti-Xa result falls exactly on a row boundary, such as 0.30, new graduates often choose the wrong row. Say: "Look at the row headings: 0.20 to 0.29, then 0.30 to 0.70. Where does 0.30 sit? Read the heading, not the feeling." Then wait.

Moment 2, the unit conversion. When a learner gives the new rate in mL per hour without first writing units per hour, say: "Write the units per hour first, then convert. Show me both numbers." The answer key requires both.

Moment 3, the double check that is not independent. When the second nurse looks at the first nurse's numbers before calculating, say: "Cover their sheet. Start from the weight and the result. Then compare." Independence is the point of the check, and checks that are not independent add little (Alsulami et al., 2013).

2. Learner Handout and Job Aid

Front: the eight steps, each in one line: read the anti-Xa value; confirm the dosing weight in the record; locate the row; note the change that row orders; work out the new dose as units/h; turn that dose into an infusion rate in mL/h; enter it through the heparin entry in the library; have a second nurse check from scratch.

Back: a worked example from start to finish with numbers, and the three most common errors found in the needs assessment, each with how to avoid it.

Written to stand alone: a new graduate who missed the session can use it at the workstation. It names the unit's nomogram and posts at each workstation, with a laminated copy at the six nurse stations.

3 and 4. Scenario Sets A and B

Each scenario gives patient weight, current rate in units per kilogram per hour, the anti-Xa result and the time. Three scenarios in each set fall exactly on a row boundary. Set B uses different numbers with the same pattern of difficulty, so that a second sitting is not a memory test.

5. Answer Keys, Kept With the Activities

Each key lists the correct row, rate change, new rate in units per hour, new rate in mL per hour and the pump entry. The keys were reviewed against the current nomogram, which follows a weight-based approach (Raschke et al., 1993), by the pharmacy informatics pharmacist on 19 October. One error in scenario A7, a rounding mistake, was found and corrected; version 1.2 contains the correction. The keys are filed in the same folder as the scenarios, so they are never separated.

6. Observation Checklist

Eight steps, each marked correct, error or not reached, with a space for the error type. Used for both sittings so that results can be compared.

7. Preceptor Sheet

One page for preceptors: what new graduates practiced, what to let them do on the unit and how to act as an independent second checker. It supports the preceptor session at the November meeting.

Dated, Versioned, Editable

Every file carries a version number and date in the footer. A change log at the top of the facilitator guide records each change: 1.1, scenario A7 corrected; 1.2, boundary wording in moment 1 clarified after the first session. Files are editable so that the educator can update them when the nomogram or the drug library changes.

Who Can Use the Package Without the Author

The clinical nurse educator ran a dry run of scenario set A on 22 October using only the guide and key, without the student present, and finished on time. That test is the reason the guide gives wording rather than headings.

How the Package Reflects the Evidence

Repeated attempts with feedback, scored against a fixed checklist, are the core of deliberate practice (McGaghie et al., 2011). The package supplies enough scenarios for at least two sittings of three attempts each.

How Set B Was Matched to Set A

Matching mattered, since the second sitting had to measure skill rather than recall. Each scenario in set B has a twin in set A with the same row, the same direction of change and a weight within 10 kg, but with different numbers throughout. The boundary scenarios in set B fall on different boundaries from those in set A, 0.70 rather than 0.30 in one case, so that a learner cannot rely on remembering where the trap was. The pharmacist checked that no set B scenario needs a calculation step that set A did not rehearse.

Format Choices

The handout uses 12-point type, a single column and bold only for the eight step names, because it is read standing at a workstation, sometimes on a night shift. The worked example sets each number on its own line with its unit, so the eye can follow units/h becoming mL/h. Color is not used to carry meaning, since the unit's printer is black and white and at least one learner may not separate red from green. Scenario sheets leave a blank box for each step so the observer can see where a learner stopped.

What Changed After the First Session

Two changes were made after 27 October. The library search problem seen in the progress notes was added to the handout as a fourth common error, with the instruction to search under heparin in the high-alert section rather than by brand name. The wording for moment 1 was tightened, because one facilitator found that "read the heading" was being heard as "read the row." Both changes appear in the change log, and the old versions are kept in an archive subfolder.

What Is Not in the Package

Clinical teaching on heparin's actions, which the hospital orientation already covers. A slide deck, which the session does not use. Anything requiring a manikin.

References

Alsulami, Z., Conroy, S., & Choonara, I. (2013). Double checking the administration of medicines: What is the evidence? A systematic review. Archives of Disease in Childhood, 97(9), 833-837. https://doi.org/10.1136/archdischild-2011-301093

McGaghie, W. C., Issenberg, S. B., Cohen, E. R., Barsuk, J. H., & Wayne, D. B. (2011). Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Academic Medicine, 86(6), 706-711. https://doi.org/10.1097/ACM.0b013e318217e119

Raschke, R. A., Reilly, B. M., Guidry, J. R., Fontana, J. R., & Srinivas, S. (1993). The weight-based heparin dosing nomogram compared with a "standard care" nomogram: A randomized controlled trial. Annals of Internal Medicine, 119(9), 874-881. https://doi.org/10.7326/0003-4819-119-9-199311010-00002