Enhancing nursing students' understanding of threshold concepts through the use of digital stories and a virtual community called ‘Wiimali’

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Highlights

  • Wiimali immerses facilitates professional transformation, and challenges students to ‘think like a nurse’.

  • Virtual communities create a sense of authenticity and allow for engagement with community members and health professionals.

  • Digital stories provide learners with a powerful and effective way to learn, remember and reflect.

  • Learners presented with a story linked to a series of facts retain significantly more than those presented with facts alone.

Abstract

Wiimali is a dynamic virtual community developed in 2010 and first implemented into our Bachelor of Nursing (BN) program in 2011. The word Wiimali comes from the Gumiluraai Aboriginal language. Wiimali and the digital stories it comprises were designed to engage nursing students and enhance their understanding of the threshold concepts integral to safe and effective nursing practice.

In this paper we illustrate some of the key features of Wiimali with web links to a virtual tour of the community and a selection of digital stories. We explain how this innovative educational approach has the potential to lead to transformative learning about concepts such as social justice, person-centred care and patient safety.

Consistent feedback about Wiimali attests to the positive impact of this educational approach. Students have commented on how Wiimali caused them to think differently about the concepts of community and social justice; how it brings the health-related problems of community members to life; and how the digital stories enhance their learning about person-centred care and patient safety.

Introduction

Wiimali is a dynamic virtual community developed in 2010 and first implemented into our Bachelor of Nursing (BN) program in 2011. The word Wiimali comes from the Gumiluraai Aboriginal language; it means to light a fire.3 Consistent with the words of William Butler Yeats we believe that ‘education is the lighting of a fire, not the filling of a pail’ and it is this premise that underpins our program. Wiimali and the digital stories it comprises were designed to inspire and engage nursing students while enhancing their understanding of the threshold concepts integral to safe and effective nursing practice. In this paper we illustrate some of the key features of Wiimali with web links to a virtual tour of the community and a selection of digital stories. We explain how this innovative educational approach has the potential to lead to transformative learning about concepts such as social justice, person-centred care and patient safety. We conclude by providing examples of student evaluative feedback about this educational approach.

Section snippets

Threshold concepts and transformative learning

Wiimali was designed to bring complex and somewhat challenging health and sociological concepts to life. These ‘threshold concepts’ are integrated throughout our BN curriculum and an understanding of them is pivotal to students' successful transition from lay person to beginning nurse. Threshold concepts are explained by Meyer and Land (2003, p.1) as:

… akin to a portal, opening up a new and previously inaccessible way of thinking about something … [they] represent a transformed way of

Wiimali

Wiimali is a virtual community located in New South Wales, Australia. While the community is fictitious the demographic indicators are representative of the diversity of a semi-metropolitan context similar to the region surrounding our university campus. Wiimali is comprised of an interactive map with over 80 digital stories, each mapped to curriculum learning outcomes and unfolding over the three years of the nursing program. The community was developed in a consultative way, inclusive of the

Curriculum integration – Year 1

Students are introduced to Wiimali in their first semester of enrolment where it forms the stimulus for a core primary health care course. The emphasis at this stage is on exploring the community, its history, demographic profile, resources, problems and assets. In Australia, education about primary health is not keeping pace with reform agendas that promote expanded roles for nurses in illness prevention and health promotion (Keleher et al., 2010). To achieve the aims of current reforms,

Year 2

In second year of the program students meet Cyril Smith, an older man diagnosed with colorectal cancer. Students follow his journey from admission, through surgery, clinical deterioration, recovery and discharge. The threshold concepts that are introduced at this stage are patient safety with particular attention to recognition and management of the deteriorating patient. Students engage with a series of interactive scenarios (Hoffman et al., 2010) based upon Levett-Jones’ (2013) clinical

Year 3

Third year students learn about disaster management when Wiimali is ravaged by a flood. They also gain an understanding of critical care nursing in the Emergency Department of Wiimali hospital when they are involved in the care of a child who has drowned in the rising flood waters of the Gubiy River and the casualties of a multiple vehicle accident at a known ‘black spot’. The threshold concepts introduced in previous years are once again reinforced. Issues related to primary health care are

Feedback about Wiimali

The extent to which Wiimali has impacted students’ world view or had a transformative effect on their understanding of the threshold concepts is difficult to ascertain. However, anecdotal feedback from students has been positive overall and has allowed us to review, refine and improve the quality of Wiimali resources and delivery over time. Additionally, routine course evaluations indicate that during the period 2010–2013, 78–90% of students either agreed or strongly agreed with the following

Conclusion

Nursing academics are continually challenged to create new ways of teaching which are contemporary, authentic and engaging for students from diverse backgrounds and with different world views. At the same time learning innovations need to be based on sound educational theory, and support the integration of threshold concepts to enhance deep learning. The development and implementation of Wiimali sought to address these challenges. A virtual community that supports transformative learning about

Acknowledgements

The development of Wiimali was funded by a Faculty of Health & Medicine, University of Newcastle grant. We also acknowledge the community members, academics, professional staff and students who have generously given of their time so that the digital stories could be produced.

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