CEP 817: Final Reflection

It has been an amazing Spring Semester of 2015. I am grateful for the teacher and classmate support, the insight and the opportunity to grow with my CEP 817 colleagues. Attached is the link to my final thoughts and reflections for the course. The definition of “Design” will forever be transformed for me into a process in which I can create, perform and solve just about anything.

MAZUREK CEP 817 FINAL REFLECTION

Respectfully,

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Paul Mazurek, RN, BSN, CCRN, CFRN, NREMT-P, I/C

Educational Nurse Coordinator

University of Michigan Survival Flight

Ann Arbor, Michigan

CEP 817: Final Report and Problem of Practice Summary

Here is the final culmination of my CEP 817 Problem of Practice project. It has been a long but fruitful process and I look forward to taking my new skill in design into my professional practice. While I still have much to learn I am encouraged by the fact that I have new resources and tools in my “tool box.”

Attached is the link to my summary and thoughts. Responses welcome.

Mazurek CEP 817 Problem of Practice and Design Thinking Summary

Respectfully,

SF Logo

Paul M Mazurek, RN, BSN, CCRN, CFRN, NREMT-P, I/C

Educational Nurse Coordinator

University of Michigan Survival Flight

Initial Testing of my Flight Nurse Internship Curriculum

My Problem of Practice is the need to design an engaging curriculum for a new Flight Nurse Internship program that I am starting in July. As curriculum design is not a skill that I currently possess, it’s hopefully clear why this is a problem. I have created a prototype design and have placed it in a makeshift Content Management System

CMS

For my testing, I used a focus group to elicit information as to how “useable” and “useful” this curriculum might be to a flight nurse in training. I met with several “would be” users, shared the prototype and my ideas for moving forward, and facilitated a feedback discussion. For this discussion, I selected 5 individuals: 2 of which are practicing flight nurses and have been for 3-5 years; 2 flight nurses who have been off of orientation (initial training) for 12 or more months, and 1 nurse still on orientation and near completion. I presented the curriculum, allowed time for open ended discussion and free flowing ideas. I then gave them a list of structured questions to answer in order to elicit needed feedback. Based upon the following Discussion Points, I created a handout and gave it to each participant in order to collect individual thoughts, feelings and ideas.

Discussion

Notes taken by the participants served as the initial set of data that I need in order to make revision. Additionally, I recorded the meeting and took notes of my own (what was said, interpretations, emotions and ideas for editing / revision). This served as an additional layer of data collection as I was able to “re-experience” the meeting. What was interesting about this is that I was able to capture additional points, thoughts and ideas that I originally missed while conducting the meeting.

After this “testing” procedure and analysis of the qualitative data that it generated, I plan on making the following revisions:

  • Changing when the intern will present information or create instruction (later in the module)
  • Adding a discussion forum for practicing flight nurses as well as interns
  • As much interactive instruction as possible (an example of this was shown and the group preferred more interaction with the instructional material than simply being presented the material)
  • Including Subject Matter Experts (SME) in instruction and / or integration of content
  • Eventual development of a “Companion Manual” to accompany core objectives and curriculum content.

Of course the “real” users will be the interns themselves. These individuals will start July 1st, 2015. Therefore a “retest” will occur when the interns are in the program and moving through the curriculum. Retesting and modification / revision will occur with similar focus group discussions at the completion of each of the 10 modules and after the first intern class is finished.

While I did get a feel for the testing process following prototype development, I think that I will truly understand this better when I immerse the interns in the curriculum. What I was hoping to accomplish with the focus group that I used was a perspective from an individual who recently experienced Survival Flight initial training. While one can argue that an internship will be quite different, I am looking for input from the learner’s perspective. This is something that I feel I did capture. With this initial testing run, I learned the value of heavily scrutinizing a product that I felt was quite solid. I learned that I do not need to have all of the answers because my users will more times than not have answers and ideas that I had never thought of (that arguably will work much better). I also learned that working hard on something and then asking for type of scrutiny that needed in order to make change is difficult but rewarding.

Flight Nurse Internship Curriculum Design Testing

So the prototype has been created in a “makeshift” Content Management System (CMS) and now it is time to test…

For my testing, I am using a Focus Group to elicit information as to how “useable” and “useful” this curriculum might be to a flight nurse in training. I have selected 5 individuals: 2 of which are practicing flight nurses and have been for 3-5 years; 2 flight nurses who have been off of orientation (initial training) for 12 or more months, and 1 nurse still on orientation and near completion. My plan is to present the curriculum to them, allowing for open ended questions and free flowing ideas while asking them structured questions in order to elicit needed feedback.

Here is my plan for testing in more “visual” format:

Questions, comments and suggestions are more than welcome!!

Flight Nurse Internship Curriculum Prototype

While my Problem of Practice is associated with constructing a curriculum for a new Flight Nurse Internship Program, I have started the “developing” within a “makeshift” Learning Management System (LMS) format (via a Google Slideshow). This has helped me to organize curriculum flow and decide what information / content I need to eventually place in the curriculum. This prototype has assisted me in the creation of a template so that I can “fill in” content as it is created. The difficult part associated with this project is not creating the information as much as deciding flow and how to implement. While I have not yet put together actual content, I do have a template and I have objectives for each module.

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THIS IS MY “HOME PAGE.” THE CIRCLED BOXES ARE INTERACTIVE THROUGH HYPERLINKING

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CLICKING THE “MODULES” BOX TAKES YOU TO…

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A PAGE WHERE YOU CAN SELECT A MODULE TO START (for our purposes, I have selected the “Airway module). Once here, the curriculum is relatively linear (e.g., validation cannot occur until the learner has reviewed the content). THE ONLY INTERACTIVE BOX THUS FAR IS THE “OBJECTIVES” SECTION

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EACH MODULE HAS ITS OWN SET OF OBJECTIVES (all objectives have been written).

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Finally, each slide has a “HOME” screen to take the learner back to the beginning

I would ask that anyone reading this blog access this Google Slideshow, place it in “PRESENTER” mode, treat it as a web-based LMS and look around with a critical eye. It is not my intent to test the LMS (after all, it is merely a Slideshow), but to evaluate whether or not the curriculum and its flow seem sound. Evaluation of actual content will occur by Subject Matter Experts at UMHS (the governing body for Survival Flight’s patient management standards).

In reflection, the process of prototyping has been the most intimidating for me. I think that it is because instead of “ideating” and “theorizing,” I was compelled to create something that may or may not be effective in solving my specific problem of practice. However, I have been reminded that failure is “OK.” In fact, it is part of learning, revising and improving. I certainly found many useful pieces of information within my brainstorming notes in order to compile and piece together what I feel will actually be a useful curriculum that will meet the goal of creating a very competent and skilled flight nurse at the end of the year time frame. Validation of these thoughts and feelings will occur quickly after implementation as I assess what worked and what didn’t work for each module. Something tells me that the content and landscape of this course of study is going to have a much different look by the completion of the tenth and final module!

Respectfully,

Paul Mazurek

There are interactive boxes within the presentation that displays some basic information.

Our Connected World

I was with my wife and youngest stepson today in Allen, MI. We were on our way back to Ann Arbor from a baseball tournament in Ft. Wayne when my wife thought it would be a good idea to stop for lunch and antique shopping (full disclosure: I am not a big fan of “antiquing” and the 10 year old even less so). Nevertheless, we stopped, had a phenomenal lunch at the Outpost Grill, and went through several antique “malls.”

While walking down memory lane, what was interesting to me was the reaction(s) of the 10 year old. He would hold up several items that I took for granted that everyone knew, and he asked me with a puzzling look “what’s this?” I would answer “that is a record, that is how we used to listen to music;” “this is a typewriter, something we would use to write letters before Microsoft Word;” “this is an instant camera, what we used to take pictures and get immediate results (well, within several minutes).”

He then shrugged his shoulders, took pictures with his iPhone of these “weird” items and then “snap chatted” them to his friends. Before this day and this trip to the “Antique Capital of Michigan,” I was really struggling with the CEP Module 5 Lab. Then it hit me, WE ARE REALLY CONNECTED!! My wife has Facebook friends from Sweden. I have made inquiries and have chatted online to solve problems with people from California, India and Norway. I have access to a larger medical library than I could ever imagine before. We are no longer limited by what we have immediately in front of us. I can send an email to a friend in Canada while texting my mother in Florida while checking the status of my wife’s flight to California (and taking / texting a picture of our dog to her). I can do this all with one handheld device!

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So I came home (while watching the Spartans beat Louisville and make it to the Final Four!!) and created the above prototype model. The shoebox represents the world. The Racquetballs on top of the Q-tip, impregnated toilet paper holders represent the people of the world. They are located in all corners of the world. Information is represented by the different colored ribbon. Notice how each person is connected to one and other by the “information.”

Amazing what a day of “antiquing” can do (no worries, made it home in time for opening tipoff)!!

CEP 817: My Brainstorming Session

My brainstorming session consisted of myself, 2 fellow flight nurses and a helicopter pilot (coincidentally, a pilot who has designed curriculum as a flight instructor!). A little rocky at first but in a period of 45-50 minutes, we went through 4 “whiteboards.”

In the first “whiteboard,” I wanted to concentrate on what I know about this internship and what I currently have at my disposal. While seemingly obvious, I felt that I needed to start at the basics in order to get the idea ball rolling. Additionally, this was the time to educate my brainstorming “team” on what the flight nurse internship would look like and the process that I see as of right now. It certainly would help them in generating ideas.

New Book - 1

We then started discussing how we were going to provide information (the learning takes place with a change in behavior).

New Book - 2

We finished the evening with developing steps in the development of this new curriculum (taking what we know, the various methods of providing information and integrating this into a standardized system):

New Book - 3

What I was looking for was direction. Between this session and my Incubation Journal, I feel that I can start piecing the components of this curriculum together.

CEP 817: My Problem of Practice Incubation Journal

It’s interesting how “mulling over ideas” can generate new ideas in a completely different direction. Carrying this spiral bound notebook with me for the better part of a week has allowed me to catalog things that have popped into my head. The first entry was on March 13th while at our annual Survival Flight Spring Conference at the Livingston County Emergency Complex in Howell, MI. This is where I started thinking about how I could use this incredible resource to provide instruction and integrate training here into my curriculum. I also started an inventory (certainly not all inclusive) of what I already have and what I could “repurpose” for my internship curriculum:

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March 16th I was at my other job at West Michigan AirCare and I began talking with one of my colleagues about curriculum design and instruction. While he has some experience with this, he is just a flight nurse like me with no formal training. Having said that, we started looking at different methods in which to provide information (not necessarily instruction):

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A couple of days later, I began my “Part 3” of my Ideate Mode exercise. Following a 45 minute, and very productive Brainstorming session with my crew (2 nurses and a pilot), my drive home gave me some time for further thought and reflection:

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Yesterday, I was able to put down on paper, how each of my 10 modules will look. This was quite a breakthrough as I feel with this template, along with my core objectives, that I can start to put together my curriculum!!

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A valuable week-long exercise that I feel started me in the right direction

CEP 817 Lab Exercise: “Mind Priming” (Actively working and thinking on my problem)

My initial thoughts, notes and great tools that I picked up while going through the Module 4 Lecture material:

  1. Mind Tools – to help me with brainstorming activities
  2. Steven Johnson: Where Good Ideas Come From ($12.99 through iBooks)
  3. Vertical Measures- Six Creative Ways to Brainstorm Ideas

Since I don’t have a great place yet to catalog resources, I will start here!

Below are my notes and initial thoughts for my problem (creating an engaging curriculum for the Survival Flight Nurse Internship Program)

CEP 817 Prob. of Practice Idea Notes CLICK PHOTO FOR AN ENLARGED VIEW

Post “Incubation” Notes and Thoughts…

  • I am not alone in this. I have practicing flight nurses who would be willing to help
    • I will need to limit the size of the task and make it quite specific
  • I will engage the interns in creating their own learning:
    • Presentations based upon objectives I give them
    • A lecture / exercise in self-directed learning
    • Interns will create small (5-15 minute) presentations on topics related to objectives. They will present to the flight nurses (increase in the stakes)
    • Weekly “Big Subject Matter” Discussions
    • Weekly “Debrief” Sessions to ensure objectives covered and “on the fly” curriculum adjustment / revision
  • Mini Brainstorming sessions during opportune times:
    • Staff meetings
    • Visits with staff during downtime
    • Case Review
    • During staff evaluation periods
  • Create lecture material based upon small “snippets” of time (“Survival Flight in 5” Concept)
  • Remainder of curriculum competency and simulation-based
  • Still at a roadblock when it comes to “INNOVATION”
  • Checklist of Big Items so everything covered

Process Reflection

Rather than a “work – incubation – revisiting the problem” lab exercise, this was a “work – incubation – roadblock – incubation – roadblock – revisiting the problem” process. The incubation period(s) definitely helped dissolve “roadblocks” for me. If anything, a little rest helped “rejuvenate” neurons long enough for some rational thought. Honestly, I was amazed at my ability to progress through part 1 of this lab exercise. From that, I was able to create several ideas as well as remember that I have things that I created previously that I can incorporate into this new curriculum. Between utilizing my previously written core objectives, ideas from other sources as to what a curriculum needs to look like, and brainstorming sessions, I feel that this will take shape.

I have learned several important pieces of information from this exercise:

  1. Taking a break can be more productive to idea creation than non-stop, arduous work on a project
  2. Innovation is a team sport. I don’t need to be the sole proprietor of this
  3. I can take what I already own and recycle it
  4. I can take what someone else owns and recycle it for a different purpose.
  5. In relation to points 3 and 4, it doesn’t always have to be “original”
  6. If innovation is important to me, I need to make time for it.
  7. Be prepared to fail, but don’t be scared of it; learn from it.

CEP 817 Problem of Practice – Define Mode (Part 2)

As stated in prior posts, I have been given approval for a Flight Nurse Internship Program. This program is designed to take competent Emergency and/or Critical Care (ICU) nurses, and turn them into competent flight nurses within a year time frame. Since this program is the first of its kind in the country, there is no one to benchmark and a problem exists in that I need to create a new curriculum, from the ground up, in four (4) months. This is a rather volatile environment from an educational perspective as demands are high and success of this program imperative given the current and future staffing crisis that Survival Flight faces. As I discovered in my Root Cause Analysis exercise, the impetus for this problem and my need to create a new program is that the demands for this job has changed to the point that finding qualified candidates to replace “seasoned” flight nurses has become exceedingly difficult.

The audience/users of this curriculum is the nurse interns themselves, as well as nursing leadership within the University of Michigan Health System (UMHS). This program demands success and there is little margin for error. Many administrators within the UMHS nursing community will be monitoring this program because of the hope that it will serve as a template for future internships in which there is a critical need (e.g., Nurse Management positions and specialty care areas).

As I feel that I have identified the needs of my primary users, the definition of my problem and the root cause for this problem, I can now purposefully formulate an action plan. As I still am unclear HOW to develop this curriculum, I will start where I normally start when needing to solve a problem: Literature Review and Benchmarking. I plan to “beg, borrow, and steal” ideas from anyone and everyone that I can think of with curriculum development experience, regardless of discipline. I plan to use my professional network that has grown significantly since my entrance into the MAET program 2 years ago. I plan to continue to read on the subject of curriculum development and innovative education. From this “raw data” I plan to piece together a curriculum based upon my core objectives that have been approved by my medical director and endorsed by our accrediting body (CAMTS). This is the direction that I plan to start and will “tweak” as I go.