Course Description
The focus of the course curriculum is the development of new neurological assessment tools for patients receiving high-dose cytarabine treatment. The course is divided into two sections focusing on problem evaluation and tool development. The first section addresses the issue of neurotoxicity of high-dose cytarabine treatment and the second section is concerned with the development and implementation of new assessment tools that can reduce the chance of permanent neurologic damage among patients undergoing cytarabine treatment.
Section 1: Problem Development
Topic 1: The Risks of High-Dose Cytarabine Treatment
Terminal objectives:
- Demonstrate an understanding of common neurological side-effects of high-dose cytarabine treatment.
- Identify common manifestations of cytarabine side-effects in chemotherapy patients.
- Demonstrate an understanding of the risks associated with high-dose cytarabine neurotoxicity.
Readings and multimedia:
- Chamberlain, M. (2012). Neurotoxicity of intra-CSF liposomal cytarabine (DepoCyt) administered for the treatment of leptomeningeal metastases: a retrospective case series. Journal of Neuro-Oncology, 109(1), 143-148. Web.
- Magge, R. & DeAngelis, L. (2015). The double-edged sword: Neurotoxicity of chemotherapy. Blood Reviews, 29(2), 93-100. Web.
Learning activities:
- Lectures;
- Assigned Readings;
- Group discussions;
Assignments:
- Readings of the two studies on the neurotoxicity of cytarabine and common neurological side effects of high-dose cytarabine treatment.
- PowerPoint presentation on common neurological side effects of cytarabine.
Topic 2: the Needs of the Patients Involved
Terminal objectives:
- Demonstrate an understanding of the needs of the patients undergoing high-dose chemotherapy;
- Identify clinical characteristics of inpatients associated with high-risks of cytarabine neurological side effects;
- Identify the deficiencies of existing assessment strategies;
Readings and multimedia:
- Rubin, E., Andersen, J., Berg, D., Schiffer, C., Mayer, R. & Stone, R. (1992). Risk factors for high-dose cytarabine neurotoxicity: an analysis of cancer and leukemia group B trial in patients with acute myeloid leukemia. Journal of Clinical Oncology, 10(6), 948-953. Web.
- Yeshurun, M., & Dupich, K. (2001). Acute cerebellar syndrome following intermediate-dose cytarabine. British Journal of Haematology, 113(4), 846. Web.
- American Cancer Society. (n.d.). Chemotherapy Side Effects Worksheet. Web.
Learning activities:
- Assigned Readings;
- Group discussions;
- Evaluation tool assessment exercise;
Assignments:
- Readings of the two studies on risk factors associated with the neurotoxicity of cytarabine.
- Essay on the needs of chemotherapy patients.
- The discussion of the effectiveness of the American Cancer Society assessment tool.
Section 2: Tool Development
Topic 1: Evidence-Based Assessment Tools
Terminal objectives:
- Demonstrate the understanding of evidence-based approach;
- Propose a possible approach to the creation of evidence-based assessment tools;
- Mapping out the process of evidence-based assessment tool development;
- Develop an evidence-based assessment tool for patients undergoing high-dose cytarabine treatment;
Readings and multimedia:
Romana, H. (2006). Is Evidence-Based Medicine Patient-Centered and Is Patient-Centered Care Evidence-Based? Health Services Research Journal, 41(1), 1-8. Web.
Learning activities:
- Assigned Readings;
- Group discussions;
- Concept mapping;
Assignments:
- Reading of the study on evidence-based medicine;
- Concept map of the process of evidence-based assessment tool creation;
- Evidence-based assessment tool for patients undergoing high-dose cytarabine treatment;
Topic 2: Practical Application of Tools
Terminal objectives:
- Apply the tools in practice;
- Collect the data and provide a comparative analysis of the findings;
- Estimate the accuracy and consistency of the information obtained;
- Use peer review to choose the most effective assessment tool;
Readings and multimedia:
Irwig, L. & Levy, S. (2004). Designing a Study. Web.
Learning activities:
- Assigned Reading;
- Application of tools in a clinical setting;
- Documentation of results;
- Group discussions;
Assignments:
- Reading the article on designing a research study;
- A research proposal;
- The application of tools in a clinical setting;
- Collection and comparative analysis of data;
Course Development Self-Reflection
To improve the quality of care, it is important to consider the evidence-based approach to making educated diagnostic and treatment decisions. Assessment tools developed using current best clinical evidence can help a practitioner improve patient outcomes by identifying symptoms of cytarabine neurological side-effects before permanent damage occurs.
Cytarabine is a common chemotherapeutic agent the neurological toxicity of which is well-recognized (Magge & DeAngelis, 2015). A high-dose cytarabine treatment is typically associated with central and peripheral nervous system dysfunctions, including dysarthria, attention deficits, and ataxic gait (Vaughn, Jarvik, Hackney, Peters, & Stadmauer, 1993). This fact necessitates the need to identify symptoms in the early stages of treatment and administer cytarabine with care to avoid side effects. The content of this course was collected and evaluated to provide a scientifically valid foundation the students can use to broaden their knowledge of the problem and develop new, effective assessment tools.
The following process was used when developing this course:
- Deciding on the research topic;
- Researching the topic;
- Reviewing the sources for scientific validity;
- Defining the objective of the course;
- Developing terminal objectives by the organizational mission and industry standards;
- Establishing an outline of the course;
- Mapping the activities of the course;
- Anticipating students questions and providing additional resources;
The course is designed to allow a level of flexibility since it introduces students to all of the concepts they might not know (Deyoung, 2009). The tone of the course is established from the beginning when students are introduced to the neurological side effects of high-dose cytarabine treatment. Such structure allows the educator to initiate a dialog with students and set expectations about the essence of the course (Harnish & Bridges, 2011).
Throughout the course, the questions of students are anticipated, and comprehensive reading material is provided to save time and reduce stress (Harnish & Bridges, 2011). The second section of the course emphasizes team-based learning and peer evaluation, which requires students to share knowledge and expertise and necessitates collaboration to achieve goals. The process of concept mapping is used to increase the students’ competence in critical thinking (Hsu & Hsieh, 2005).
The project’s terminal objectives are designed in such a way so that they are aligned with the mission of the organization, which is to use the evidence-best approach to provide high-quality medical care. Terminal objectives necessitate cooperation and collaboration, which are essential in today’s complex healthcare settings. According to industry standards, terminal objectives emphasize the care to be patient-focused, rather than task-focused and rely heavily on communication with the patient to improve patient satisfaction and health outcomes (Irwin & Richardson, 2006).
References
DeYoung, S. (2009). Teaching strategies for nurse educators. Upper Saddle River, NJ: Pearson.
Harnish, R. J., & Bridges, K. R. (2011). Effect of syllabus tone: Students’ perceptions of instructor and course. Social Psychology of Education, 14(3), 319-330.
Hsu, L. & Hsieh, S. (2005). Concept Maps as an Assessment Tool in a Nursing Course. Journal of Professional Nursing, 21(3), 141-149. Web.
Irwin, R. & Richardson, N. (2006). Patient-Focused Care*. CHEST Journal, 130(1), 73S-82S. Web.
Magge, R. & DeAngelis, L. (2015). The double-edged sword: Neurotoxicity of chemotherapy. Blood Reviews, 29(2), 93-100. Web.
Vaughn, D., Jarvik, J., Hackney, D., Peters, S. & Stadmauer, E. (1993). High-Dose Cytarabine Neurotoxicity: MR Findings during the Acute Phase. American Journal of Neuroradiology, 14, 1014-1016. Web.
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