As podcasts become more common in the classroom,1 their precise role and benefits continue to be explored. Universities routinely offer internet-based lecture recordings as a means of increasing educational accessibility.2 Studies demonstrate that students appreciate the increased mobility and convenience that podcasts offer,1 whereas others suggest that podcasts may promote critical thinking in nursing education.3 However, there are additional benefits to podcasting.
Kearsley and Shneiderman4 envisioned that technology could facilitate and simplify tools critical to student learning and engagement such as participation, collaboration, and problem solving. Although their work was published in 1998, prior to the advent of podcasting, Gipson and Richards5 have more recently identified podcasting as a technique to promote a learner-centered experience. They proposed that podcasts' ability to be heard in a variety of environments under learner-controlled conditions could be used as an adjunct to traditional teaching strategies to encourage student participation and shift instructional paradigms from a teacher-centered lecture format to a learner-centered experience.
Influenced by the potential benefits offered by technology, we developed a 4-episode series of interprofessional podcasts to be used during an advanced practice nursing seminar for adult geriatric nurse practitioner master's degree students. The podcasts were used in combination with an extensive, unfolding written case study to explore concepts in geriatric pharmacology.
Background
During the final year of their curricula, 16 adult/geriatric nurse practitioner students participated in a seminar emphasizing an evidence-based approach to clinical decision making. The seminar consisted of 10 classes meeting weekly, in person, throughout the quarter. Each class involved discussion of cultural, socioeconomic, and diversity factors in the delivery of patient-centered primary care to older adults. The seminar was supported by an online educational platform through which the students accessed the syllabus, reading materials, and assignments. Because of in-class time constraints and the complexity of the material, it was decided that geriatric pharmacology was an important component of the class and should be presented separately from the in-person classes using an online, interprofessional format.
An online unfolding case study was developed by nursing, medical, and pharmacy faculty to demonstrate common geriatric pharmacologic considerations. Students were given access to the unfolding case study through the online course platform. The unfolding case followed a single patient as she encountered 4 scenarios common to older patients. After each scenario, a series of questions was presented for students to answer using the appropriate literature, guidelines, and principles learned during the previous quarter's pharmacology lectures. An electronic discussion board was developed to allow students to work together and share resources. Students submitted answers to the questions through the electronic platform, and once answers were submitted, students were given access to a postcase podcast, featuring a conversation-based review of the assignment questions. On completion of the course, we solicited evaluations from students to determine if they found value and interest in the approach.
Unfolding Case Study and Assignments
The extensive case study was based on a fictional 82-year-old woman, Myrtle, who was seen in the primary care clinic with a number of evolving complaints. Through the course website, students were given access to Myrtle's profile, including health history, insurance coverage, medical history, medication list, allergies, and other pertinent information. The unfolding case was separated into 4 distinct sections. During the first section, students followed Myrtle as she presented to her primary care provider with a urinary tract infection. The case presented a description of Myrtle's symptoms, most recent laboratory tests, and other pertinent information. Following the unfolding case, students were assigned questions focusing on the process for evaluating, diagnosing, and treating each presentation. Students had a week to review the case and complete the assigned questions, at which point the assignment was submitted. The case study assignments were graded as complete or incomplete, and all 4 case assignments represented a total of 10% of the class grade.
Every 2 weeks, students were given access to new components of Myrtle's unfolding case, complete with new assignments. Students followed Myrtle through a total of 4 separate appointments including presentation for urinary tract infection, common gastrointestinal complaints, adjustments to her thyroid medications, and questions about vaccinations. Visits were progressive, so students were able to follow up on previous interventions.
Postcase Podcast
Once students electronically submitted their responses, access was given to the postcase podcast. Students could download the podcast and listen at their convenience on any electronic device of their choosing, thus increasing the mobility and accessibility of the lesson. Podcasts were conducted by a nurse practitioner faculty member and a clinical pharmacist, both with experience in geriatric primary care. A separate podcast was recorded for each of the unfolding case assignments and consisted of a 15- to 20-minute conversation in which the 2 clinicians introduced and recapped the pertinent case, questions asked, readings and guidelines, and common pharmacologic considerations. The conversation-based format allowed for incorporation of storytelling and humor as tools to encourage student engagement. Comments made on the student discussion board were discussed during the conversation, and each podcast was concluded with a summary of recommendations and key points.
Student Evaluation
Student engagement and attitudes were measured using a survey distributed at the end of the seminar. Of the 17 students, 13 students (76.5%) returned the survey. All of the respondents listened to at least 3 of the 4 episodes, and 84.6% listened to all 4 podcasts. Responses to the case study/podcast format were overwhelmingly positive. Students commented that the approach was "one of the most helpful and informative things of this quarter" and contained "very useful nuggets of information to use in practice." When asked what changes should be made for future courses, recommendations were to either make no changes or add more podcast episodes. All of the respondents indicated that the podcasts increased the educational value of the case study and the approach was useful to their clinical growth. Finally, an open-ended format asked students what aspects of the approach detracted from their learning. Two students identified background noise of the podcast as a potential distraction, and 2 students identified class logistics (eg, grading weight of the assignment), among other comments.
Summary
We developed an unfolding case study and podcast series to demonstrate interprofessional collaboration and promote student learning and engagement. Students responded to the approach with high levels of participation, positive evaluations, and an appreciation for diverse aspects of the podcast. Students identified the interprofessional and conversation components of the podcast as being a helpful and informative demonstration of interprofessional collaboration. The unfolding case and postcase podcast approach seemed to be a promising storytelling technique, as many students commented that they developed a strong connection to Myrtle, the fictional patient of the unfolding case study. This was an unexpected benefit of the approach, but we believe that by using a case study and podcast the seminar simulated an actual patient with multiple progressive encounters. As students followed Myrtle and actively discussed, reviewed, and commented on her care, they developed a sense of familiarity, which contributed to their engagement and learning. Students also commented that they appreciated the innovation in pedagogical approach and expressed a desire to see further incorporation of this model in future courses. Nursing programs have an opportunity to create active learning strategies with this resourceful use of podcasting with collaboration across disciplines.
References