Learning As Scaffolding
Whether she’s at the hospital, bedside, or teaching in virtual classrooms, clinical instructor Donna Bindig brings warmth and humanity to every course she teaches. Helping undergraduates build psycho-motor skills at the bedside, she considers learning in architectural metaphors: a carefully-laid foundation of practice, the rise of scaffolding with new competencies, and the painstaking personal work required to construct technically skilled, capable, compassionate nurses. Throughout the build, Bindig constantly reminds students they’re cared for and cherished: a spirit she reminds her students to offer to their future patients, too.
Here, she shares thoughts on her teaching process during the pandemic, her drive to nurture students' knowledge and well-being, the silver linings afforded by Zoom, and how the "essence of nursing" she shares remains unchanged.
ON HER INITIAL WORRIES
“My first thought? I don’t know how to teach online! The tech was new to me, and learning how to initiate Zoom meetings and have two-hour virtual classes with my students, who I’d normally be in the hospital with.
“Our classes are small … and in a way, Zoom is even more intimate. I could see the expressions on their faces, I could see if they were struggling with something, or had a hard time answering a question. I see both their verbal and nonverbal communication. Then I could ask the question in a different way.
“At the beginning of each class, especially in those early days, I’d focus on one student at a time. They’d share their personal concerns. I’d share a little of my own concerns or frustrations so they could feel my humanness. I’d say, ‘I wish I could be different,’ but would try to put a positive spin on it. We’d talk. I’d ask them:’ Was there any silver lining that came up for you this week?’
“Even though I missed having them at the hospital, I was able to see their beautiful faces every week, and lighten their load, comforting them—trying to, anyway—and being an active listener. I was using the same teaching techniques I always do, but it was in a virtual setting.”
HOW CLINICAL SKILLS ARE TAUGHT ONLINE
“[Simulation software] ATI offered us ways to practice nursing concepts that some of our second-year students didn’t have enough real-life practice in, like organization, time management, prioritizing care, working collaboratively and communicating with other members of the healthcare team to meet patient objectives. Delegation, for instance, is a hard skill for our younger nursing students to become comfortable with—they feel a little unsure, especially how to delegate tasks to, say, a patient care tech—so we used those lessons. We also used ATI to strengthen students’ foundational learning, and review topics: oxygentation, concepts in diabetes, prioritizing care.
“We’d watch videos of a nurse and patient, read short articles on best practice, and review discussion questions. Then we’d talk, and students related what they’d done in taking care of the patients in the scenarios offered. They’d draw from the experiences that they had earlier in the semester in clinicals, and then we’d talk about what we might do better next time.
“It’s really learning as scaffolding. We use the foundations they have, do review, and take time and not rush. Students hone foundational skills, like physical assessment, therapeutic communication, and other specific basics: how to bathe a patient, make a bed, take a manual blood pressure, put on and take off PPE. We’ll do lots of review before we dive into new learning. If you don’t use it, you lose it, so we spend time refamiliarizing ourselves.”
“Our students are very mature in their thinking, both their critical thinking personally and professionally, and they understood that while in-person learning is best, this was the next best thing. We tried to make it as interesting and even fun for them as we could.”
ON SILVER LININGS
“In many ways, I do like [online learning]. It doesn’t replace the real thing, not by any means—being in a patient’s room with my nursing students who are taking actual physical, mental, spiritual care of their patients. But what we did is probably the next best thing.”
“I liked that the program was based on evidence-based best practice, and so I felt comfortable in my students’ learning about whatever topic was at hand. Whether it was diabetes care, wound care, oxygenating a patient who needs it—I felt comfortable that the knowledge they were receiving was strong, and I liked the discussions that ensued. They related the learning to what they did in real time in a real-life setting, and observed what they could do better. [They’d say] ‘Gee, next time, I might do this differently, or incorporate this concept I hadn’t thought about before.’
ON WHAT’S TO COME THIS FALL
“When we get together this fall, whether it’s online or in person, I’ll do the same thing I always do: I’ll share a little about who I am, we go around and do ice breakers asking some questions. I’ll ask how they are so they know, that they can see, that we really care about them. There’s a real level of safety in that.”
“Now that we have this virtual venue, we’ll be able to have more impromptu faculty meetings. It doesn’t all have to be on email; we can talk face-to-face together, as faculty, to brainstorm about strategies to resolve a problem or concern. It’ll be more collaborative in solving problems and concerns and coming up with new ideas.”
ON HER KEY TAKE-AWAYS FOR NURSES, NO MATTER THE FORMAT
“Each faculty member brings what they feel the essence of nursing is; I tried to bring that in our virtual classroom. I want my students to feel it’s a privilege to care for their patients who are at their most vulnerable. They’re suffering, whether it’s physically, or mentally, or spiritually, and they’re allowing us into their world. We’ve always got to respect and honor that. I always say, ‘You’re going to see at the end of your clinical day that you’ll feel like the patient gave more to you than you did to your patient.’
“Teaching psychomotor skills is important, but the essence, the art of nursing is in the innate compassion we have for other people. I want my students to experience that, and grow in that realm.”