Practicum Project: Neurological Assessment

Introduction

The instructional model and method play a visible role in the success of the educational activity. Properly chosen learning methods that are aligned with the goals and objectives of the project streamline the selection of techniques, simplify planning, and eliminate unexpected difficulties. The following paper analyzes the model and methods chosen for the implementation of the practicum project, tests their relevance and alignment, and details the reasons behind the selected activities.

Content Area and Focus

The chosen practicum project aims at developing an appropriate neurological assessment for patients undergoing cancer treatment and integrating the suggested assessment techniques in recovery practices of Baptist Health of South Florida. While the negative effects of chemotherapy are well recognized in medical theory, there is no consistency in the suggested methods for its mitigation.

The primary reason for such a gap is the fact that there is no single unified procedure to evaluate the severity of neurological dysfunction or even its presence (Jean-Pierre, Johnson-Greene, & Burish, 2014). Thus, my project focuses on the existing nursing practices to determine whether it is possible to expand them to include simple and cost-effective assessment tools to improve patient outcomes and at the same time increase understanding of the phenomenon and create a source of meaningful data to further expand the knowledge base of the neurological effects of ARA-C.

Topics and Objectives

The treatment-related neurocognitive dysfunction associated with chemotherapy, including the use of ARA-C, is generally acknowledged across cancer care establishments. However, its adverse effects are currently assessed by collecting and processing patient reports on perceived cognitive difficulties, which are understandably subjective and thus unreliable. The use of psychometrically validated neuropsychological tests, while more reliable, lacks an evidence-based approach and produces results of limited applicability (Jean-Pierre et al., 2014).

These discrepancies understandably undermine the consistency and integrity of the quality of patient care and thus conflict with the mission and vision of maintaining the highest standards of clinical and service excellence.

Therefore, the objectives of the practicum project are centered around developing an evidence-based approach to improving the consistency of responses to their needs and thus providing superior outcomes. Importantly, the objectives also include maintaining safety without compromising cost-effectiveness, since the majority of preconceived assessment tools (e.g. handwriting exercise) do not require state-of-the-art equipment and emphasize staff proficiency and performance in securing a high level of care.

Justification

To reach the goals and effectively achieve the milestones set for the course of the practicum project, the following combination of the instructional model, instructional method, and learning method is recommended.

Instructional Model

The instructional model which aligns best with the set objectives and goals is ADDIE (Analysis, Design, Development, Implementation, Evaluation) (Almomen et al., 2016). The analysis phase, which includes analyzing audience, behavioral outcomes, delivery options, and timeframe for learning, can already be preconceived without the need for further inquiry. The design phase presents further opportunities for the development of the practicum since it can be based largely on the existing theoretical basis on the neurological studies and thus does not require time-consuming in-depth research.

In the development phase, the pre-existing material, as well as the newly obtained information, can be systematized and transformed into a meaningful delivery program, which then can be applied to practice on the implementation phase. Finally, at the evaluation phase, the effectiveness of developed techniques is measured, and required adjustments are made. Such a barebone structure provides an opportunity for a streamlined process which, in turn, allows to minimize organizational effort and focus instead on the set objectives.

Instructional Method

The method for the suggested project can be precisely defined using six dimensions proposed by Edmonds, Branch, and Mukherjee (1994). Since the ultimate goal is the creation of the nursing environment which is beneficial for improved patient outcomes, the preferable orientation of the project is prescriptive, although descriptive elements are also present in the chosen model on the analysis phase. According to the type of knowledge, the method is purely procedural since it focuses on the development of suitable methods of delivery rather than the reason for the exercise, which is visible in the mission of the establishment.

The expertise requirements exclude the novice level since the topic requires proficiency in the scientific method and specific knowledge of neurological care. Most of the structure can be constructed using the existing theories without a visible need for prototyping. Therefore hard systems are preferred theoretical origins. Finally, both institutional context and level are predetermined since the project is designed with a specific audience in mind.

Learning Method

The indirect instruction learning method was chosen to process the information, although a minor clarification is necessary. While the traditional interpretation of indirect instructions suggests that students are expected to derive meaning from existing information and the strategies outlined by the teacher (Jurkowski & Hänze, 2015), in this particular case, several limitations are present, mostly resulting from the strict rules of the evidence-based practice.

Thus, while the lack of well-defined standards makes it impossible to arrive at a predetermined status quo (which means that the application of a direct method is excluded), the necessity to follow guidelines in devising assessment tools and applying them, as well as the need for innovation, narrows the choice of learning methods to transactive (but not purely indirect instruction) ones.

The rationale for the Chosen Methods

The model and methods described above were selected by applying the criterion of suitability for the outlined goals and derived means of achieving them. For instance, the ADDIE model is relatively simplistic and omits some of the currently favored elements of education and training, such as the emphasis on problem-oriented learning. However, despite these seeming disadvantages, this model fits well within the development and implementation of an evidence-based approach.

In other words, its robustness is sufficient for the relatively straightforward goal of developing a specific assessment technique and excludes the presence of secondary objectives by prioritizing structure and efficiency. The six-dimensional characteristic was chosen for similar reasons: the majority of available instructional methods offer a narrowed-down description specific to more or less widespread educational activities with understandably few focusing on the less common events such as workshops or other projects aimed at developing novel approaches to existing issues.

The six-dimensional framework, on the other hand, offers a somewhat cumbersome yet precise description of the project, which enhances our understanding of the preferred tools and techniques. Finally, the transactive learning method provides an accurate description of the most likely approach to the problem – in other words, it is highly consistent with the chosen topic.

Alignment Analysis

Model and Method Alignment

The six dimensions outlined in the previous chapter allow us to describe a fairly accurate model that coincides with the suggested ADDIE model. For instance, the required expertise criterion clarifies the identification of constraints on the analysis phase and can be used as a basis for the list of competencies, skills, and knowledge necessary for the design phase (Davis, 2013). The prescriptive orientation defines the desired techniques for implementation and, to some degree, the evaluation methods used in the final phase. In essence, we can say that most of the points of the instructional method find their reflection in concurrent elements of the respective phase.

Topic and Objective Alignment

Besides, as was mentioned earlier, the simple and systemic structure of the model aligns well to find evidence-based assessment techniques: the clear and well-defined criteria for inquiry eliminates possible waste and creates a more focused structure of the process. Since the theoretical background for the neurological testing is diverse, and the studies supporting the current goal (establishing the evidence-backed technique of assessment based on a predetermined and well-defined tool) are scarce, the learning method must discourage wavering and specify patient outcomes as a baseline.

At the same time, creativity and flexibility are required to reach the set objective, which is a conflicting demand. However, the transactive learning method, especially its indirect instruction variety, suggests the necessary freedom during the course development without compromising the reliability of the resulting data.

Influence on Learning Materials and Educational Technology

Naturally, the chosen methods require a specific approach in terms of learning technology. For instance, the transactive method traditionally relies on the interaction among students, as well as between students and a teacher. Thus, dialogue and discussion will likely take center stage. Some other techniques, such as brainstorming and debate, may be used, although certain caution is advised since these methods are known to be less systematic and thus require scrutiny. Case studies and controversial issue analysis is also recommended for implementation, which, in turn, confirms the need for reliable sources and the skill to process data.

Evaluation and Selection of Learning Materials

First, because of the evident reliance on verifiable and falsifiable scientific data, the selected reading materials should be from reputable peer-reviewed scholarly sources. The course books should also be checked for the credentials of the authors and publishers. The web materials, including podcasts and videos, are allowed for use during the course as long as the data presented in them are properly referenced and is consistent and up-to-date.

However, they can only be used as a supportive source of information and substituted with primary source whenever possible unless not related directly to the studies on neurological disorders or statistical data. Classroom activities should be assigned similarly: on the occasions where scientific credibility plays a direct role (e.g. determining the efficiency of a certain technique or intervention), the activities would likely be limited to discussion with the necessary level of verification of claims.

On the other hand, the goals aim at the largely under-researched area of patient care, so on some occasions less structured activities are acceptable, such as the brainstorming mentioned above coupled with appropriate data systematization and coding to eliminate irrelevant results (Mythili, Gandhi, Thirumoorthy, & Muralidharan, 2015). Finally, due to the highly systemic nature of involved knowledge the preferred classroom assessment techniques include minute papers and one-sentence summaries, with the occasional inclusion of more interaction-oriented methods such as student-generated tests to cross-evaluate the audience.

Conclusion

The goals set for the practicum project introduce visible limitations to the process of selection of instructional model and method, as well as the appropriate classroom activities and information sources. However, these limitations also introduce transparency and clarity to the process. The emphasis on systematic and verifiable data narrows the focus and eliminates unnecessary options. For this reason, the chosen model and method align well with the goals, objectives, and topics of our project and create a clear set of requirements for appropriate classroom activities.

References

Almomen, R. K., Kaufman, D., Alotaibi, H., Al-Rowais, N. A., Albeik, M., & Albattal, S. M. (2016). Applying the ADDIE—analysis, design, development, implementation and evaluation—instructional design model to continuing professional development for primary care physicians in Saudi Arabia. International Journal of Clinical Medicine, 7(8), 538-549.

Davis, A. L. (2013). Using instructional design principles to develop effective information literacy instruction The ADDIE model. College & Research Libraries News, 74(4), 205-207.

Edmonds, G. S., Branch, R. C., & Mukherjee, P. (1994). A conceptual framework for comparing instructional design models. Educational Technology Research and Development, 42(4), 55-72.

Jean-Pierre, P., Johnson-Greene, D., & Burish, T. G. (2014). Neuropsychological care and rehabilitation of cancer patients with chemobrain: strategies for evaluation and intervention development. Supportive Care in Cancer, 22(8), 2251-2260.

Jurkowski, S., & Hänze, M. (2015). How to increase the benefits of cooperation: Effects of training in transactive communication on cooperative learning. British Journal of Educational Psychology, 85(3), 357-371.

Mythili, D., Gandhi, S., Thirumoorthy, A., & Muralidharan, K. (2015). Short-term impact of traditional versus innovative teaching strategies on mental health knowledge among undergraduate nursing students in India-a pilot study. Asian Journal of Nursing Education and Research, 5(1), 8-21.