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Disaster Response Training for Saudi Nurses Essay (Critical Writing)

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Introduction

The present paper discusses the development of a disaster response lesson plan for the nurses of the metropolitan hospital in the Kingdom of Saudi Arabia. Disaster can be viewed as a natural or human-made event, which results in a disruption of the normal flow of life (1-2). The key competencies that the nurses are expected to demonstrate in the case of such events include coordination, teamwork, and leadership skills in addition to decision-making and clinical skills (3-4). Unfortunately, nurses tend to report being uncertain about their education and training in the area (1, 5). As a result, it appears necessary to resolve this issue by providing additional training.

The present paper is devoted to a detailed discussion of the lesson plan, including its components and the implementation strategies. The lesson employs a simulation, has a distinct active learning approach, and focuses the learners’ attention on patient-oriented care. It is concluded that the lesson can be of use for clinical government because it has the potential of improving the quality of the service at the hospital. A table with a summary of the lesson and a figure with a force field analysis is also incorporated.

Teaching and Learning Plan

For the proposed plan, the learners are assumed to have varying levels of baseline knowledge and skills. In general, there is evidence to nurses experiencing difficulties in acquiring appropriate knowledge and experience concerning disaster response in a variety of countries (4, 6), including Saudi Arabia (1). In particular, recent studies show that Saudi nurses demonstrate a moderate level of competency, which varies from hospital to hospital, and they tend to report being insufficiently prepared (1, 5).

In other words, they have limited confidence in their abilities, which also tend to require improvement. As a result, the educator’s goals for the proposed lesson include the improvement of the learners’ knowledge and skills as well as the enhancement of their self-confidence. The role of nurses in disaster response is crucial (1, 4, 7), which highlights the significance of the proposed lesson.

The effectiveness of simulations in increasing various nursing competencies, including those related to disaster management, is well-documented (2, 8-12). However, it is noteworthy that some studies may demonstrate the relatively low effectiveness of simulation activities (13). While the reasons for this inconsistency is not apparent, it can be suggested that the specifics of the lessons can have an impact. As a result, it appears particularly important to provide a detailed plan for the proposed lesson to improve the efficiency of the method.

Set-body-closure: a table

Table 1 offers a detailed overview of the activities of the learners and teacher, as well as the assessment techniques used and the timeline suggested. It should be pointed out that up to ten learners are supposed to be engaged in the lesson. In general, the set of the lesson is expected to include the discussion of the key terms with an emphasis on the learners’ experience and their ability to provide critical analysis and synthesis of the notions of disaster management and patent-oriented care. The body involves the work with the simulation, including relevant instruction, facilitated participation, and critical self-assessment.

The closure presupposes the final evaluation and a reflection on the lesson; the teacher is supposed to draw the learners’ attention to the key outcomes and conclusions that they have achieved during the lesson. Also, the teacher will ask the learners to provide some feedback on the lesson while considering the effectiveness of its methods, which should be performed in the form of a questionnaire. This feedback will be used for the teacher’s evaluation of the lesson; it might also provide ideas for the improvement of the plan. To sum up, the lesson emphasises active learning activities like discussions, and group work views the teacher as a facilitator (which is also typical for active learning) and provides several assessment methods throughout the lesson (including questions, simulation performance, and self-assessment).

The Behavioural Learning Objectives (BLO) for the lesson can be described as follows. The learners are supposed to critically review and enhance their knowledge and understanding of the topic, learn to apply the theoretical knowledge about disaster management in practice, and acquire and improve their skills in the critical areas required of a nurse in the case of a disaster. The latter skills predominantly include decision-making, teamwork, leadership, and patient-oriented approach use (3-4).

Finally, the nurses are supposed to boost their self-confidence with respect to their skills and knowledge. The improvement of knowledge can be visible through discussions, simulation activities, and question responses. The application of the knowledge and skills performance are demonstrated predominantly through the simulation, but the learners’ self-assessment can also be of importance for this objective. The final BLO can be reviewed during the nurses’ self-assessment. Thus, the BLO is observable, specific, learner-oriented, and tangible, which should make them appropriate (14). The teaching and learning activities can be found in Table 1.

Table 1. The set, body, and closure of the lesson.
Learner’s Activities Teacher’s Activities Evaluation of Learning Time
SET

BLO: review and enhance the knowledge on disaster management.

  • Individually list and analyse their disaster-relevant experience.
  • Discuss and make conclusions about the critical nurse competencies in disaster management.
  • Discuss the idea of using simulation for disaster management training. Apply their knowledge of the specifics of the event to their knowledge about the learning approach.
  • Asks learners about their experience in disaster management.
  • Disaster management nurse competencies discussion (facilitates the discussion; uses blackboard to pinpoint the most important ideas). Steers conversation towards a patient-centred perspective.
  • A short discussion of simulation as a learning approach and its appropriateness for disaster management training.
Teacher reviews the learners’ ability to analyse the topic of disaster management from various aspects, including patient-centred care. Up to 20 minutes.
BODY

BLO: learn to apply the knowledge in practice; acquire and improve critical skills (decision-making, teamwork, leadership, patient-centred care skills).

  • Listen to the teacher’s instruction.
  • Ask for clarifications.
  • Participate in the simulation.
  • In simulation: practice nursing, decision-making, communication, teamwork skills. Apply theoretical and practical knowledge. Use the patient-centred approach.
  • Critically assess and reflect on their actions.
  • Identify key challenges and discuss achievements.
  • Critically assess the effectiveness of the simulation.
  • Provides simulation-related instruction. Points out the importance of patient-centred approach. Ensures that every learner understands the instruction (invites questions).
  • Responds to questions.
  • Checks every learner’s progress; offers required guidance and help.
  • Asks every learner to assess their actions with a focus on achievements and difficulties. Reminds about the patient-centred approach. Encourages them to use the information for change plan development.
  • Asks two-four volunteers to make a conclusion about the simulation and its contribution to their understanding of the topic.
  • Simulation performance (progress; the application of the key ideas; patient-centred approach).
  • Learner self-assessment.
Up to 1 hour and a half; should involve a short (10-15 minutes) break (before the change of the roles).
CLOSURE

BLO: boost the self-confidence of the nurses concerning the topic; also, all the three BLO mentioned above.

  • Respond to and ask questions.
  • Perform a short reflection exercise in groups of three-four people.
  • (Optional) provide feedback on the course.
  • Responds to and asks questions.
  • Provides appropriate guidance for the reflection assignment. Encourages self-reflection through instruction.
  • Distributes and collects the course assessment questionnaire.
  • The teacher asks random learners key questions. Other learners can add relevant information.
Up to 20 minutes

Conditions, resources, physical requirements, and teaching aids

The key teaching aids of the proposed lesson are going to be connected to the simulation, and it can be either virtual or non-virtual depending on the provided funding and technical equipment (10). For the present lesson, a non-virtual simulation is offered, but the plan can be easily adapted to correspond to a virtual one. In particular, a role-play simulation is suggested: it has proven to be a rather low-fidelity (12), but a still effective type of simulation, which has been used for disaster management training in nurses with noticeable success (2). The proposed equipment for the simulation includes the forms for the evaluation and assessment of the victims as well as “victim tags,” that is, the tags, which provide the information on the injuries of the people role-playing as “victims” (2).

Other requirements for the lesson include a classroom with enough space for the activities of a ten-people group and a blackboard, flipchart, or another similar piece of equipment that can be used for writing down key information. Finally, the nurses and the teacher need to be provided with a sufficient amount of time off. If they have a whole day off, they are likely to be more focused and less tired. Thus, the proposed lesson does not require many resources, which makes it particularly feasible.

Patient-Centred Elements: A Discussion

The patient-centred approach refers to the type of care that does not focus on treating diseases and conditions; instead, it provides the care for the patient, which typically presupposes the development of holistic solutions in collaboration with the patient (15-16).

Dwamena provides an overview of 43 randomised trials, which show varying levels of the effectiveness of the approach. In general, this study indicates that the approach is likely to be beneficial for different outcomes of care, including patient health. As a result, the proposed lesson incorporates the patient-centred approach as the key method and works to contribute to the development of this approach in the participants. In particular, the role of the teacher as a facilitator is used to steer the learner’s discussion and practice towards a patient-centred approach, which is reflected in Table 1.

Strategies for Implementation

Timeline and communication

Table 1 contains information on the timeline of the lesson. It is meant for a class with no more than ten people, which is why the proposed timeframe seems quite generous. It is also relatively flexible and is supposed to include a break at the point when the simulation implies the change of roles. In the lesson, the information is going to be communicated in a mixed way that will be oriented towards several styles of learning, including auditory, visual, and kinaesthetic ones (17). Indeed, much of the information is supposed to be provided verbally, but key points are going to be written down. Also, the process of simulation is appropriate for visual, auditory, and kinaesthetic types of learning. Thus, the lesson takes into account the different needs and preferences of the learners.

Force Field Analysis

Force Field Analysis (FFA) is a tool that was developed by Lewin to assess the forces that either help or hinder the change (18). The forces are multiple phenomena, and they can refer to factors of very different origin: from financial ones to those related to people’s attitudes (19). The former can be termed as enabling forces, and the latter are barriers to the implementation of the teaching and learning plan. FFA is critical for understanding the process of change and using this knowledge to reduce barriers and employ enabling forces to the benefit of the situation (19).

When applying the method of analysis to the lesson, one can suggest that some multiple enablers and barriers should be considered. Some of them can be paired: for example, the lack of hospital approval is an apparent barrier while the approval of the management of the hospital is likely to provide multiple benefits for the lesson, including the preparation of resources. Similarly, engaged learners are enablers, but the learners who exhibit resistance to the lesson (for example, to the method of the simulation) are going to create barriers.

Both pairs of factors should be managed in a way that allows avoiding or reducing the barriers; as a result, management approval should be found, and learners need to be motivated. Concerning the simulation issues, it can be suggested that the Set discussion on the method can resolve such a problem if it appears.

Force Field Analysis for the lesson.
Figure 1. Force Field Analysis for the lesson, which is loosely based on Shirey’s figure (19).

Learner experience and knowledge are enablers, and they are employed in the plan during the set. It is also noteworthy that the nurses have various levels of experience and expertise, which implies that the processes of co-creating and sharing knowledge can be particularly beneficial for younger and less experienced learners as well as the learners who have had less training in the field of disaster management (14).

This enabler is employed in group activities. In contrast to these factors, the possibility of varied learner needs can result in obstacles. For example, the lesson takes into account different types of learning styles, but some are favoured, especially the auditory one. Also, the lesson is an active learning one, which can be viewed as a challenge by less active and particularly modest learners. The lesson tries to engage everyone in conversation and assessments. It offers learners the opportunity to discuss the simulation in smaller groups, which can be viewed as a solution to this particular issue. Other issues should be addressed when discovered.

Finally, the challenge of resources, including time, funding, equipment, can be mentioned. It should be pointed out that the lesson has a rather generous timeframe for the proposed number of learners and that the non-virtual simulation does not require expensive equipment. As a result, this issue can be avoided to an extent. The final version of FFA is presented in Figure 1.

Key stakeholders and their roles

The key stakeholders in the process include the nurses and the teacher. The nurses are a group of both male and female specialists who currently work at the metropolitan hospital in the Kingdom of Saudi Arabia. Their key role in the process of the lesson consists of engaging in active learning as the learners. Active learning can be opposed to didactic learning, and it is a learner-centred technique, which presupposes engaging learners in their learning and the development of their knowledge (20). In other words, instead of passively absorbing the information provided by the instructor, the nurses are expected to actively develop their knowledge in a meaningful collaboration with the instructor and each other. The features of the proposed lesson that are directly related to active learning are group activities, discussions, and reflection (self-assessment) exercises (20).

While learners are expected to play a critical part in the learning process, the role of the teacher in active learning is still rather important. In particular, Millis demonstrates that the engagement of learners depends on a notable extent on the activities of the teacher. These activities include the setting of clear goals, consistent planning of active learning elements, and tracking the forces, especially resisting ones, that can affect the process of the plan’s implementation (20). It is also noteworthy that appropriate instruction is capable of prompting learners to employ higher-order thinking: that is, the thinking of higher levels as suggested by Bloom (23).

While lower levels of thinking are not to be disregarded (such as remembering, understanding, and using knowledge), higher levels (the ability to analyse and synthesise as well as evaluate) must be achieved through appropriate goal-setting and approaches to learning. In other words, the role of the teacher in active learning can be described as that of a facilitator who plans, implements and continuously monitors the process, helping the learners to develop their knowledge. Some of the teacher’s and learners’ activities in the plan directly refer to higher levels of thinking in Table 1; also, the table contains other facilitator actions in the teacher’s section.

Other stakeholders can also be mentioned; in particular, the management of the hospital has a vested interest in training their nurses, and its collaboration can be of use for the lesson. For example, the hospital can offer help in providing the environment for the lesson, ensuring that the nurses are provided with time off for their training, and, possibly, facilitating the acquisition of some of the equipment. As it was mentioned, the achievement of the approval of the management can be a great enabler for the proposed lesson.

Clinical governance

The notion of clinical governance refers to the system which both demands that health service providers proceed to improve the quality of their service and provides the frameworks and tools for doing so (22). The development of clinical governance is viewed as critical for modern healthcare, and so is the notion of quality improvement (23). The improvement is supposed to be guided by evidence and continuous review of the changes (24).

While the content of the lesson is directly concerned with the improvement of quality in the field of disaster management, the lesson in itself can be viewed as an element that is capable of improving the quality of disaster management in the nurses of the metropolitan hospital and, potentially, other hospitals. From this point of view, the fact that the lesson has an inbuilt mechanism for self-improvement (the questionnaire), is particularly beneficial because the implementation of this plan allows developing and customising it (24). Thus, the introduction of the lesson plan into the regular disaster management drill of the hospital can be viewed as a change, which has the potential of improving the quality of service in the facility.

Conclusion

The present report provides a lesson plan, which is aimed at reducing the self-doubt and improving the knowledge and skills of the Saudi nurses working at the metropolitan hospital. In particular, the lesson targets disaster management, which is reported to be a difficult and typically underdeveloped area of nursing expertise, and patient-centred approach, which is viewed as very important for modern nursing. The teacher goals and the learning objectives include the knowledge, skills, and self-confidence improvement. The plan focuses on the active learning approach, and it utilises several relevant techniques, including discussions, group activities, and self-reflection.

The latter is also one of the forms of assessment; other assessments that the lesson uses include the simulation performance and questions. The implementation plan shows that the teacher should pay attention to FFA, and it also demonstrates the plan’s ability for self-development and quality improvement. The current paper uses several tools (the Set-Body-Closure structure, FFA) to discuss, analyse, and improve the proposed lesson plan; to produce a more customised version, a couple of implementations are required.

References

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