Flipping the Classroom in Nurse Education

With demand for nurses already at its highest point and climbing steadily, clinical educators are under enormous pressure to get newly hired and trained nurses caring for patients as quickly as possible.

The best approach to getting nurses up to speed quickly? A flipped classroom – a type of blended learning that reverses the traditional learning environment, making content available at a “need-to-know” level to get staff trained and moved to productivity quickly.

The global nursing shortage spans beyond borders and acute care; however, hospitals everywhere are confronting the hard realities of the current nursing crisis: Nursing turnover rates at all-time highs –made worse by the heightened demand for nurses in a rapidly transforming healthcare ecosystem. In fact, a recent study found that the U.S. needs to hire 2.3 million new healthcare workers by 2025 to aid the country’s aging population. As demand for skilled nurses increases, 17% of newly registered nurses (RNs) will leave their first job within the first year, and that figure rises to one-third within the first two years.

 
 

 $4 - $6 million 
 Nurse shortages and high nurse turnover is costing US hospitals

 
 

A flipped classroom – or blended learning approach – is a worldwide phenomenon increasingly popular in training healthcare professionals. This offers the best solution to get nurses onto the hospital floor as quickly as possible, armed with the knowledge they need to carry out their roles with confidence while continually growing their expertise over time. These educational programs combine different learning techniques, such as online digital media and traditional classroom methods, that deliver “just in time” knowledge.

In traditional learning programs, students acquire knowledge through teacher-led classroom instruction and they are then sent away to synthesize, analyze and evaluate what they’ve learned. In the flipped classroom, students acquire their knowledge before class, and then use classroom time to apply these concepts. This focus on application of knowledge and situational reasoning, especially within the context of a clinical scenario, is vital to the success of the nurse at the bedside, and growing this specific skill over time is of the utmost importance to improving patient outcomes.

Practicing with confidence

In its publication, The Future of Nursing: Leading Change, Advancing Health, the Institute of Medicine (IOM) has noted that nurses are in a unique position to partner with other healthcare professionals to drive improvements and redesign of the broader healthcare system. But to enable nurses to fulfil this role, it’s imperative that they have both the need-to-know orientation training to make them productive, and ongoing professional education to deliver improved patient care and outcomes.

A blended learning environment helps to achieve both of these objectives by combining learning techniques with other tools to improve knowledge retention. New nurses get the evidence-based orientation training they need to ensure they carry out their roles competently and thoroughly. But it doesn’t stop there. Ongoing professional development programs that are adapted to the needs of the organization and learning style of the individual provide opportunities for growth, also helping to reduce the high turnover rate.

Putting knowledge in the hands of nurses: a case study

As a large Ohio and Kentucky-based network, with 23 hospitals and more than 8,000 registered nurses, Mercy Health was attempting to manage variability in care, and determine how orientation costs were impacting budget and productivity.

To address the situation, Mercy established some clear objectives:

  • Overcome a nurse turnover rate of 15%.
  • Ensure good orientation to help new nurses carry out their roles competently and confidently.
  • Drive greater accountability across all hospitals and units for successful orientation outcomes.

Mercy Health’s clinical education team undertook a lessons-learned initiative to determine what type of educational program would best suit their needs. Requirements included: the flexibility to adjust to their specific orientation needs; a solution that would fill quality gaps in existing programs with the most recent evidence-based information; and one that would address cost and human resource restraints.
 
Mercy Health’s solution provides a single source of truth, allowing it to build a robust orientation and professional development program. Importantly, the program lets nurse educators adapt processes to suit the way each individual learns and build learners’ skills and capabilities over time. Blended learning provides the flexibility for nurses to advance their knowledge in different ways – in the classroom, online, and by testing out their situational reasoning skills. This leads to strong learning outcomes and gets new RNs onto the floor quickly, but also safely and proficiently.

Results:

Standardization across all hospitals has enabled Mercy Health to achieve:

  • Cost savings – as much as $50,000 per year
  • Reduction in turnover rate of approximately 12.3%
  • Positive feedback from graduates
  • Greater structure and guidance for educators 

Going forward with confidence

As hospitals battle to reduce nurse turnover rates and prepare nurses for their role in an increasingly complex care environment, healthcare systems will need to find ways to improve and standardize orientation and ongoing professional development programs. They can begin by defining their current state and ask themselves how well orientation programs are affecting budget and productivity.

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