Title : Measuring senior baccalaureate nursing-students’ learning-transfer evidence using a disaster scenario tabletop-exercise
Background: Little is known about learning-transfer in baccalaureate nursing-students or the use of tabletop-exercises as a classroom strategy in nursing education. Optimal learning-transfer is the learner’s ability to use original learning during time distanced novel circumstances (Perkins & Salomon, 1992). Tabletop-exercises are objective designed classroom activities (FEMA, 2008a; 2008b) where participants solve practice problems providing formative assessments for competencies, policies, and procedures, or all. Decision-making using nursing process (ANA, 2015) is critical to achieve quality, safe patient care. Basic disaster and medical-surgical concepts are expected graduate baccalaureate abilities (AACN, 2008). Senior baccalaureate nursing-students’ learning-transfer evidence of vetted basic disaster and medical/surgical concepts was measured using a tabletop-exercise during an approved institutional review board study at a metropolitan university.
Method: During the tabletop-exercise, students (N = 114) functioned in the role of new generalist professional nurses on a medical-surgical hospital unit with a full census and completed a basic disaster-nurse competencies test first. Then a disaster circumstance created the need to open space, staff, and supply resources for an unanticipated disaster patient surge to the hospital that required admission. Students assessed their assigned patients for acuity, functional abilities, and resource needs to then determine their inpatient disposition recommendations. The exercise ended as students debriefed their disposition recommendations to the exercise objective to open resources for the incoming disaster victims. Students then completed a questionnaire that captured self-reflections of previous learning use during the tabletop-exercise. Students’ iterative use of nursing process and decision-making, as learning-transfer evidence, was data captured for statistical analysis on three new instruments piloted early is the dissertation process. The Disaster-Knowledge-Test (CVI = 0.96; r = 0.54), the Tabletop-Attitude-Questionnaire (CVI = 0.89; r = 0.77), and the 86-decision criterion-referenced Tabletop-Matrix. Disaster-nurse experts’ evaluated the inpatient scenarios (CVI = 0.95) and disposition agreement (0.95). Interrater agreement to researcher answer keys by medical-surgical experts was (0.95-0.98).
Results: Data provided quantitative learning-transfer evidence baselines for the vetted concepts identifying aggregate sample strengths and gaps. Research instrument relationships were also examined. The Disaster-Knowledge-Test and Tabletop-Matrix had no statistical association (r (108) = 0.139, p = 0.074) while the Tabletop-Attitude-Questionnaire and Tabletop-Matrix relationship was weak (r (109) = 0.26, p = 0.004).
Conclusion: Aggregate vetted concept learning-transfer evidence was measured during a tabletop-exercise. The tabletop-exercise provided a classroom experience using decision-making during a novel circumstance, just as a nurse would do in practice.
Audience Take Away:
• Describe a tabletop exercise
• Define Perkins and Salomon’s Learning-Transfer
• Generate shared meaning of how a disaster-emergency tabletop-exercise can be used to measure learning transfer