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Kim, Kim, Park, Park, and Park: The Development and Application of a New Problem Based Learning Module for Students in an Advanced Practice Nurse Program for Oncology
Original Article

Asian Oncol Nurs 2018;18(3):127-134.

Published online: 5 September 2018

DOI: https://doi.org/10.5388/aon.2018.18.3.127

The Development and Application of a New Problem Based Learning Module for Students in an Advanced Practice Nurse Program for Oncology

Hee-Ju Kim1, Jeong Hye Kim2, Jeong Yun Park2, Jeong-Sook Park3, Eun Young Park4

1College of Nursing, Catholic University of Korea, Seoul, Korea

2Department of Clinical Nursing, University of Ulsan, Seoul, Korea

3Keimyung University College of Nursing, Daegu, Korea

4College of Nursing, Gachon University, Incheon, Korea

∗ This article was financially supported by the Council of Korean Oncology Nursing Society.

Address reprint requests to: Kim, Jeong Hye Department of Clinical Nursing, University of Ulsan, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-5335 Fax: +82-2-3010-5332 E-mail: kimjh@amc.seoul.kr

Received 28 Aug 201810 Sep 2018       Accepted 16 Sep 2018

Copyright © 2018 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

초록

Purpose

The purposes of this study were to develop a problem based learning (PBL) module for cancer symptom management and oncology emergencies, and to evaluate the module after applying it for students in an advanced practice nurse program for oncology.

Methods

This study was a methodological research project. We invited a total of 13 graduates from an advanced practice nurse program to evaluate topics for the PBL module development. Five experts developed a PBL module for a selected topic. Eight students from an advanced practice nurse program participated in the PBL learning experience and evaluated their learning experiences.

Results

Tumor lysis syndrome, pain, disseminated intravascular coagulation and hypercalcemia were evaluated to be the most relevant and needed topics for the module. Oncology emergency PBL module-tumor lysis syndrome was developed through expert validation. Evaluation of PBL learning was 3.76 (out of 4 points) in a pilot test.

Conclusion

The new PBL module provided a positive learning experience to students. The new PBL module can be used as the standardized clinical practice education in the oncology advanced practice nurse program and developing further PBL modules for different topics is recommended.

Keywords: Problem-Based Learning, Advanced Practice Nursing, Oncology Nursing

REFERENCES

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TLS= Tumor lysis syndrome; DIC= Disseminated intravascular coagulation; CVI= Content validity index; APN= Advanced practice nurse.
aon-18-127f1.tif
Table 1.
Selecting Topics for Problem Based Learning for Advanced Practice Nurse for Oncology (N =13)
No. Item description M ± SD
1. Fatigue 3.08 ± 0.64
2. Menopausal symptoms 2.77 ± 0.44
3. Pain 3.85 ± 0.38
4. Sleep disturbances 3.23 ± 0.60
5. Hypersensitivity 3.77 ± 0.44
6. Infection 3.77 ± 0.44
7. Constipation 3.38 ± 0.65
8. Diarrhea 3.46 ± 0.52
9. Nausea and vomiting 3.62 ± 0.51
10. Malignant ascites 3.15 ± 0.56
11. Bleeding and thrombotic complication 3.54 ± 0.52
12. Dyspnea 3.38 ± 0.51
13. Cachexia 3.23 ± 0.44
14. Dysphagia 3.08 ± 0.28
15. Stomatitis 3.38 ± 0.51
16. Xerostomia 3.00 ± 0.41
17. Peripheral neuropathy 3.54 ± 0.66
18. Alopecia 3.31 ± 0.63
19. Body image disturbance 3.15 ± 0.56
20. Sex health 3.08 ± 0.50
21. Extravasation 3.46 ± 0.66
22. Lymphedema 3.23 ± 0.60
23. Organ toxicity 3.15 ± 0.56
24. Skin toxicity (hand foot syndrome, skin rash) 3.54 ± 0.52
25. Anxiety 3.15 ± 0.56
26. Depression 3.15 ± 0.69
27. Cognitive dysfunction 2.92 ± 0.49
28. Spiritual distress 3.15 ± 0.69
29. Symptoms of dying cancer patients 3.46 ± 0.66
30. Increased intracranial pressure 3.77 ± 0.44
31. Superior venacava syndrome 3.77 ± 0.44
32. Effusions 3.00 ± 0.58
33. Hypercalcemia 3.85 ± 0.88
34. Disseminated intravascular coagulation 3.85 ± 0.88
35. Tumor lysis syndrome 4.00 ± 0.00
36. Syndrome of inappropriated secretion of anti- diuretic hormone 3.69 ± 0.48
37. Sepsis 3.77 ± 0.44
Table 2.
Problem based Learning Module on Tumor Lysis Syndrome: Tables of Contents
Contents Items
Learning goal 1. Through this learning, objective and subjective data can be collected to identify the patient's problems.
  2. Through this learning, physical examination can be performed to assess the patient's problem.
  3. Through this learning, clinical symptoms according to the patient's problem can be explained.
  4. Through this learning, diagnosis based on the patient's problem can be deduced.
  5. Through this learning, intervention for prevention of patient's problem can be suggested.
  6. Through this learning, therapeutic intervention to solve the patient's problem can be explained.
  7. Through this learning, nursing intervention according to the patient's problem can be performed.
Clinical scenario 1. Clinical case
  2. Vital sign
  3. Test result: laboratory, image (Computed tomography), biopsy (Gastrofibroscopy, Bone marrow)
PBL guidelines 1. What are the problems that this patient presents?
  2. What are the additional tests that need to be done to identify the patient's problem?
  3. What are the additional symptoms that should be assessed to identify the patient's problem?
  4. What physical assessment techniques should be used to identify the patient's problems?
  5. What caused this problem for this patient?
  6. What if I set up a way to prevent this problem?
  7. What the treatments/interventions would you plan to solve this problem? What is the evidence for this?
  8. What nursing interventions should you perform in this case?
Table 3.
Evaluation of PBL Learning Outcomes (N =8)
Items M ± SD
1. PBL has helped to improve knowledge acquisition and learning methods (data collection, information management). 3.75 ± 0.46
2. PBL has been instrumental in promoting critical thinking and reasoning skills. 3.75 ± 0.46
3. PBL has helped to enhance the skills of self and students to evaluate each other. 3.88 ± 0.35
4. PBL has helped promote autonomous learning ability. 3.75 ± 0.46
5. PBL has helped to increase mutual teaching skills among students. 3.63 ± 0.74
6. PBL has helped students increase their ability to listen to others and cooperate with one another. 3.75 ± 0.46
7. I think PBL was a good experience. 3.88 ± 0.35
8. PBL is needed for the nursing curriculum. 3.75 ± 0.71
9. The preparation and presentation of the other students in the group helped me. 3.75 ± 0.46
10. I think learning through group activities will be helpful for clinical practice. 3.75 ± 0.46
Total 3.76 ± 0.37

PBL = problem-based learning.

검사명 참고치 단위 항암화학요법 당일 2일째
WBC 4~10 ×103/uL 7.0 9.0
Hb 12~16 g/dl 11.2 10.8
Hct 39~52 % 44.0 45.0
Platelet 150~350 ×103/uL 175 185
Calcium 8.6~10.2 mg/dL 9.0 6.8
Phosphorus 2.5~4.5 mg/dL 8.1 14.2
Glucose 70~99 mg/dL 99 100
Uric acid 3~7 mg/dL 9.5 11.9
Creatinine 0.70~1.40 mg/dL 0.8 1.4
BUN 10~26 mg/dL 13 73
Sodium 135~145 mmol/L 140 135
Potassium 3.5~5.1 mmol/L 3.9 5.3
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