Well, it is time to share some good internet information with all of my nursing friends out there. I had more than one thought this week so I am writing about a few issues
Health Assessment Resources on the WWW
Key to the foundational knowledge of any nurse is the ability to perform an exemplary health assessment, whether beginner or returning to school for a graduate nursing degree. The internet has provided a new medium through which to reach students at any geographic location at virtually any time of day. This makes access, comprehension, and visual/audio opportunities unending for our students. The following websites offer great supplemental learning of the physical examination through interaction, video, and audio.
The Health History: Of note, before I progress into this further, I want it to be known that I feel the most important part of any health assessment is not the physical exam, but the health history. A good, complete, and culturally competent health history will not only direct the examiner toward potential problems, but inform about areas of preventative needs and patient education, such as the need for adult immunizations, smoking cessation, or even grief counseling. Many of these things cannot be discerned by the physical exam alone. The physical exam is an unfortunate emphasis of many health assessment classes and basic RN programs. Unfortunately, the internet echos the same gap in emphasis with numerous physical examination resources and very few health history examples, forms, reasoning, etc….
The Physical Exam: I am not going to belabor the things we all know about a health history. Providing a warm room, privacy, equipment, good lighting, WASHING the HANDS in front of the patient, and actually meeting and talking with the patient, clothes on, before they don an ultra comfortable and stylish examination gown is basic groundwork for a good exam. There is truly an art to the physical exam and starting at the head and working your way down (head-to-toe) is best, helping to keep things organized. The following internet video/audio/interactive websites are excellent adjunct additions to any health assessment course, or simply as a refresher.
OPETA website from the University of Florida – http://opeta.medinfo.ufl.edu/
LEARN HOW TO EXAMINE website from Dr. Diane Davitt, PhD, RN – http://www.webster.edu/~davittdc/index.html
LEARNERS TV Video Examination Series – http://www.learnerstv.com/lectures.php?course=ltv032&cat=Medical&page=1
THE INTERACTIVE GUIDE TO THE EXAMINATION at OSU – http://medicine.osu.edu/exam/Pages/index.aspx
How to Make a Podcast for Your Course, to Send to Someone, or For Anything Else
Audio podcasts are a great way to ‘verbally’ connect with students and people, without the need for synchronicity in schedules. They also offer a great way for lectures, thoughts, etc. to be downloaded to iPods and played over and over. I am continually surprised at how many of my colleagues find this notion ‘scary’ and therefore resort to the same methods of communication without trying new ones. It is one of the easiest things in the world to do, so here is a step by step to help you along….
For you PC users (yes that means WINDOWS)
1. Go to the little search box in your start menu and type in Sound Recorder.
2. You will then need a microphone of some sort, many laptops now come with this ‘built in’ so when you hit the red record button you are good to go, however…. many desktop computers do not. A great plug-in headset like this one from Logitech can be purchased cheaply. (I have a new noise canceling one that loads in my USB and it totally ROCKS)…. anyway….
3. Simply make sure your microphone and headset are working and hit record.(I recommend having a script ready and reading through it a few times or your lecture notes handy).
4. You have now made a recording. Save the file to where you like and give it a unique name. NOW…. there is more to do… you can’t just post this file, because it is not an MP3 file its a .wav.
5. Download a great free MP3 file converter like this free converter touted by CNet.
For you Mac Users
1. To make easy MP3 recordings Mac is going to ask you to buy Quick Time Pro. If you already have this, then simply open it and record away and save as an MP3 file.
2. For those of you who don’t have Quick Time Pro, I recommend free recording software like Audacity for Mac.
3. Once you install it to your applications folder, simply open it, and click in on the red button to record. Remember to make sure your headphones and microphone work (see above PC directions), practice your recording, and then record and save. (There is a great You Tube tutorial here.)
4. In this Audacity software you need to be sure to EXPORT your file as an MP3 file to get your podcast, from the file menu. Do not save it as an audacity file. (You will need the LAME plug in to convert this to an MP3 file. Do not worry, this is painless. Just download it at the time of your Audacity download. They run simultaneously.)
It is easy, quick and can be loaded to most LMS, even e-mails and webpages. How cool is that?!!
Other Thoughts…. One of my internet friends, Rob Fraser, asked me, in response to a blog post, a very important question that academic faculty and students need to ponder about the internet. He asked if copyright would be an issue when students post papers and assignments to the WWW. I have to say that the answer to this is both yes and no.
Yes, because if students post a paper to their blog without citations or references then there are some major copyright violations, however they should be learning proper formatting in school. ‘Yes’ also because if students turn the same paper in for more than one course (a NO-NO for you students) then plagiarism programs like TurnItIn should pick up on those and alert the instructor. Students should not post their papers until after turning them into the course instructor and should also alert the instructor that the assignment has been posted to the student’s blog as well. (note* This is good brownie points for you students and really gets some great miles out of the things you are turning in. I am a firm believer that the world needs to see what students are working on. I avoid this problem all the way around as I will discuss below.)
No…. I say ‘No’ because the student’s work belongs to them and if they are writing and publishing their own blog, then they can post their work their without copyright infringement or plagiarism. I always caution students to make issues they write about devoid of direct patient information and at first when they begin to post I have them use assignments that are not specific to patient encounters, until they get the hang of de-identifying writing. Further, I simply avoid the entire TurnItIn issue with their work by having them only turn things in through blog postings in one of my classes. Creating and maintaining blogs teaches a bit about social media, encourages good writing output from the outset, and offers a continuing forum for students to practice written communication.
I also say ‘No’ because I think that we nursing faculty have a big hang up with the importance of the assignments we create. We cause our students much strife by creating varying writing assignments in courses with different topic sets, thus not allowing our students, even at a basic education level, to develop a body of knowledge that they can command. For example, BSN completion students often work in specific clinical areas where they have some expertise. Generic BSN students and even MSN students, although gaining basic nursing science foundational knowledge, often have subject areas they are interested in or want to know more about. We, nursing faculty, need to facilitate this curiosity from their first writing assignments so that they can continually build this body of knowledge and interest throughout their program of study. Say a student is interested in lung cancer, then in their cultural class let them write about cultural issues in some aspect of nursing patients with lung cancer, in community health let them write about lung cancer prevention, in leadership let them implement a change project concerning lung cancer, and in theories and research let them write a literature review or concept analysis on some aspect of lung cancer.
If we begin to use technology to enhance nursing learning and begin to think ‘outside the box’ in ways that our students can synthesize and express knowledge, the whole of health care will be much better served. Go NURSING!