C919 essay 2.0

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Western Governors University *

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C919

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Health Science

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Dec 6, 2023

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1 Writing Facilitation of Context-Based Student-Centered Learning: Course Outline Katrina E Andryushchenko Leavitt School of Health, Western Governors University C919: Facilitation of Context-Based Student-Centered Learning Dr. Alpert 11/21/2023

2 Facilitation of Context-Based Student-Centered Learning Aspects of the Course This eight-week Community Health Nursing course is designed to prepare the forty enrolled students to take care of their communities by introducing crucial roles and responsibilities of the community health nurse. This course introduces topics such as foundations of community health, social, epidemiological, socioeconomic factors that influence community health, assessment of community needs, vulnerable populations, and analyzing community data, planning interventions for community needs,diverse ethical and cultural considerations in the community, leadership in community health nursing, public health policies, community education of health and lifestyle changes. These essential topics in this community health course will prepare the BSN student nurse to provide culturally competent, professional, and knowledgeable care to their local communities. Not only will students act as change agents and leaders for community change, but they will also learn to recognize various community cultural and health needs, analyze data to promote health, and advocate for appropriate interventions through policy development. The topics of this community health course are aligned with the BSN core competencies and essentials of professional nursing practice (American Association of Colleges of Nursing [AACN], 2008). Students will also participate in active learning strategies, such as concept mapping, interprofessional collaboration simulations, group discussions and presentations, and case studies will be utilized to promote a student-centered learning environment and outcomes. This course is relevant to nursing practice in that it teaches students important community health nursing concepts such as health promotion, analysis of community needs, and applying appropriate interventions. These concepts are crucial to understand and apply because they pave

3 the way for the professional nurse to deliver quality care to their communities. By participating in active learning strategies, such as real-world simulations and case studies, students will experience the real-world of nursing care of their communities. After this course, students will be able to provide care to their communities that aligns with current professional nursing practice. Cultivation of Course This eight-week Community Health Nursing course builds upon each week to promote student-centered outcomes. The course starts with the foundations and history of community health nursing. This helps establish a baseline for the ‘how’ and ‘why’ of community health nursing. The course in week two then moves into various factors that can affect community health. Building from the first two weeks, where students learned what health issues and factors are most prevalent in the community setting, students in weeks three and four learn, through the nursing process, to assess, analyze, plan, and intervene in the various health problems of the community. In week five, students will analyze various cultural and ethical issues and considerations when taking care of their community. This will help prepare them for week six and seven, where they learn what it is to be a nurse leader and the process of policy development. It is essential for the students to understand culturally competent nursing and how to assess for various cultural needs and understand any ethical issues before they step into the leadership role where they assume responsibility, collaborate, and communicate with other professionals within the community, and understand what policies are crucial in public health nursing. This way, students are well-rounded and culturally sensitive healthcare professional leaders in the community setting. Lastly, in week eight, students will build upon all the previous weeks of knowledge to learn how to educate their communities on health and lifestyle changes. In each

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4 week, students will be introduced to key concepts, and their competency will be evaluated in student-centered active learning activities. Student-Centered Learning Student-centered learning is an instructional approach that places the learner at the center of the educational experience, encouraging active participation, critical thinking, and independent exploration (Berg & Lepp, 2023). Learning the key concepts along with active learning activities in each week goes hand in hand with promoting student-centered learning. In week one, the history of the community health nurse is introduced. Concepts like the foundations and importance of the community health nurse, their roles throughout history, and the community health nurse today will be presented. Students will engage in and learn this key concept through a group discussion of different topics within the history of the public health nurse. The group discussion is a great way to engage students and encourage active participation, and independent exploration of the topic. The group discussion is a great way to put the students in the center of the learning environment. In week two, the key concept is Healthy People 2030: Social Determinants of Health (SDOH). Here, students will be taught, and later independently explore the Healthy People 2030 website and identify the SDOH that are important for the analysis of factors that can affect community health. By allowing the students to explore the website on their own and pull information that stands out to them is a fantastic way to promote independent student-centered learning. In this week, after exploring the website, the students will be assigned groups where they will develop a PowerPoint presentation of an SDOH of their choosing. This active learning strategy will allow the students to work together and teach their fellow classmates about the key concept, thus putting students in the center of their learning experience.

5 In week three, risk factors for vulnerable populations will be introduced. Students will be able to identify various risk factors for certain populations by creating concept maps that will go along with a certain vulnerable population (homeless, veterans, foster children etc.). Concept mapping will allow students to create connections between important community health topics and concepts, this way taking an active role in their learning. Week four will introduce students to evidence-based practice (EBP) interventions for community health needs. Students will participate in an interactive case study to explore different EBP health interventions. They will solve the health problem in their case study by applying their chosen EBP intervention, thus taking part in student-oriented learning. In week five, students are introduced to transcultural nursing. They will understand the importance of culture within the community and how it relates to a variety of needs within the community. Through a cultural immersion experience, students will be able to provide culturally sensitive care, and see how it effects the care of people from diverse cultures within their community. This experience will allow students to learn different cultures and their needs hands- on, thus delivering student-centered learning. Week six will introduce the students to interprofessional collaboration and communication vital to the continuity of care within the community. Students will actively engage in an interprofessional collaboration simulation where they take an active part in learning the different roles of professionals in the community and the importance of communication to promote community health. In week seven, students will learn the policy development process and relevant stakeholders to the process. They will be able to actively participate in a legislative advocacy session, thus learning hands-on the importance of policies within the community to benefit the health and safety of everyone in the community. In the last week, students will

6 evaluate the health literacy of their community to provide education within their community. Students will engage in role-play and discuss why the assessment of health literacy is an important aspect of community education. These last three key concepts all promote student- oriented learning by applying active learning strategies to help students experience and learn the lesson hands-on. Professional Standards and Guidelines Table 1 discusses how each weekly key concept from the course outline aligns with the “The Essentials of Baccalaureate Education for Professional Nursing Practice” (AACN, 2008). Table 1 Key Concept Alignment with Professional Standards and Guidelines Weekly Key Concept Competency Alignment Explained Week 1: History of the Community Health Nurse Essential VIII: Professionalism and Professional Values The student nurse will possess historical knowledge of nursing care practices and the importance of modern- day nursing issues and their impact on nursing practice and professionalism today through class discussions (AACN, 2008). Week 2: Healthy People 2030: Social determinants of health Essential VII: Clinical Prevention and Population Health Students will learn to identify determinants of health within their communities and prioritize interventions to promote population health as outlines in essential VII (AACN, 2008). Week 3: Identify Risk factors for vulnerable populations (i.e. homeless, veterans, foster children) Essential VII: Clinical Prevention and Population Health The BSN student nurse will learn to identify vulnerable populations through risk factors, recognize clinical prevention strategies, and how they can promote community health by creating concept maps (AACN, 2008). Week 4: Evidence-based Essential III: Scholarship for The student nurse will display

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7 interventions for community needs Evidence-Based Practice scholarship of evidence-based practice by utilizing research and applying evidence-based interventions for the benefit of the population through EBP case studies (AACN, 2008). Week 5: Transcultural Nursing Essential VII: Clinical Prevention and Population Health In this key concept, the BSN prepared student nurse will participate in a cultural immersion experience to assess the beliefs, practices, and culture of the patient to provide culturally competent care within the community to promote population health (AACN, 2008). Week 6: Interprofessional collaboration within the community Essential VI: Interprofessional Communication and Collaboration for Improving Patient Health Outcomes Through collaborative simulations the student nurse will learn practical interprofessional communication skills to deliver evidence-based, patient-centered care to improve patient health outcomes (AACN, 2008). Week 7: Policy development process and relevant stakeholders within the process Essential V: Healthcare Policy, Finance, and Regulatory Environments The student nurse will understand the policy making process, relevant stakeholders, and the nurse’s role in policy development and patient advocacy by actively participating in a legislative advocacy session (AACN, 2008). Week 8: Evaluating Health Literacy within the community Essential VII: Clinical Prevention and Population Health The student nurse will assess health literacy, through role- play and discussion, of their community in order to deliver patient-centered education to promote population health (AACN, 2008). Alignment of Weekly Key Concepts to Overview

8 The course overview is a summary of the concepts that students will learn in this Community Health Nursing course. The first week key concept, History of the Community Health Nurse, directly relates to the focus of the Foundations of Community Health Nursing because it provides students with a historical background, thus laying a foundation for community health nursing concepts. The second week key concept, Healthy People 2030: social determinants of health, directly relates to identifying factors that influence community health in the course overview because students will be able to identify various SDOH factors that affect community health after learning this key concept. In the third week, students will identify risk factors for vulnerable populations, such as poverty, no health insurance, and growing up in foster care, which directly relates to assessing for community needs as outlined in the course overview. In the fourth week, students will be able to apply evidence-based interventions in the community and this directly relates to the nursing process of intervening to meet community health needs as stated in the course overview. In week five, the students will learn to provide transcultural nursing care which aligns with the course overview which states that the BSN nurse will be able to provide culturally and ethically appropriate care. In week six, students will learn to collaborate with multiple professions and communicate effectively to advocate for and promote patient-centered care. This aligns with the course overview description that the BSN student nurse will be able to act as a nurse leader within their community. In week seven, students will learn about the policy development process and its importance in public health nursing; this key concept directly relates to the course overview description that the BSN student nurse will have knowledge of relevant public health policies. In the last week, students will evaluate the health literacy in their

9 community in order to, as the course overview states, provide health education that is relevant and understandable to community members. Course Outline Relevance As a nurse educator, creating a comprehensive course outline is essential for effective curriculum design, student engagement, and successful course delivery. It is a valuable tool for planning, communication, and assessment, contributing to a positive and impactful learning experience for students. First, a course outline helps define clear learning objectives and outcomes. This clarity ensures that students understand what is expected of them and provides a roadmap for the educator to guide the learning process effectively. As a nurse educator, having well-defined learning objectives allows me to align course content with specific educational goals, ensuring students acquire the necessary knowledge and skills. Next, the course outline aids in structuring and organizing the curriculum logically. It helps in sequencing topics, ensuring a coherent flow of information, and facilitating a progressive understanding of complex concepts. For a nurse educator, a well-organized course outline is essential for delivering content in a structured manner, making it easier for students to grasp and retain information. The outline also serves as a guide for developing assessments that align with the learning objectives. It ensures that assessments accurately measure the attainment of desired knowledge and skills. As a nurse educator, aligning assessments with the course outline allows for practical evaluation of student progress and helps tailor teaching strategies to address any identified gaps in understanding. The course outline communicates student expectations regarding assignments, assessments, and participation. It provides a clear understanding of the workload and fosters student engagement. As a nurse educator, setting clear expectations through the course outline promotes a positive learning environment, encourages student accountability, and helps manage

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10 student expectations regarding the rigor of the course. A course outline also assists in identifying and organizing the resources required for effective teaching, including textbooks, articles, multimedia materials, and guest speakers. As a nurse educator, this ensures that I am well- prepared with relevant resources, contributing to the overall quality of the learning experience for students. While providing a structured plan, the course outline should allow flexibility to accommodate unexpected events or opportunities for enrichment. As a nurse educator, the ability to adapt the course in response to student needs or emerging trends in healthcare ensures that the education provided remains current and relevant. Lastly, the course outline is a communication tool between educators, students, and administrators. It provides a shared understanding of the course structure and content. For a nurse educator, effective communication through the course outline fosters transparency, supports collaboration, and enables stakeholders to engage in the educational process actively. Learning Strategies The first learning strategy is an interactive case study in week four. Students will engage in interactive case studies that present real-life community health scenarios. They analyze, discuss, and propose solutions collaboratively. Interactive case studies provide visual stimuli through scenarios, charts, and graphs for visual learners. For auditory learners, group discussions and collaborative problem-solving cater to their learning needs by allowing the students to talk and hear information. Hands-on analysis and solution proposal activities engage kinesthetic learners. This learning strategy effectively accommodates different learning styles, ensuring students with varying preferences can actively participate and comprehend key concepts (Thanaphakawatkul et al., 2023).

11 The following active learning strategy is a cultural immersion experience in week five. Students will participate in a cultural immersion experience, engaging with a community from a different cultural background to foster understanding. For visual and experiential learners, immersive experiences cater to those who learn best through real-world experiences. Interpersonal learners get to engage with diverse communities. This allows students to interact and build relationships, catering to interpersonal learners. Recognizing and respecting diverse learning styles aligns with the course's focus on cultural competence, ensuring learners can adapt and relate to different cultural perspectives (Leyva-Moral et al., 2023). The last learning strategy is concept mapping for week three. Concept mapping requires learners to identify relationships between different concepts and organize them hierarchically. This process encourages critical thinking as students must analyze, synthesize, and evaluate information to create meaningful connections. Learners have different preferences for acquiring and processing information. Concept mapping allows for customization, enabling students to represent information in a way that aligns with their learning style, whether they are visual, auditory, or kinesthetic learners. By drawing out a concept map and making connections between points of information, this learning strategy strongly caters to the needs of visual and kinesthetic learners. Community health nursing is practical and applied. Concept mapping goes beyond rote memorization and encourages the application of knowledge to real-world scenarios catering to the needs of interpersonal learners. Students can use concept maps to develop care plans, interventions, and strategies tailored to the specific needs of diverse communities (Kalu et al., 2023). Implementation of Learning Strategies

12 The learning strategy that will be implemented to address the various learning needs of students is the interactive case study in week four, Planning Interventions for Community Needs. The first step in implementing this learning strategy is to ensure that the selected case studies represent a variety of community health needs, addressing the diverse interests and backgrounds of the learners. This allows students to connect with topics that resonate with their experiences or passions. Next, it is essential to form groups that include individuals with different learning preferences and strengths. This ensures a mix of visual, auditory, and kinesthetic learners in each group, promoting peer-to-peer learning and collaboration. Third in this implementation process is to provide case study materials to students in various formats, including written scenarios, visual aids, and audio clips. This accommodates different learning styles, allowing students to engage with the content in ways that align with their preferences. It is also crucial to employ a mix of discussion, hands-on activities, and multimedia presentations to explore and analyze case studies. This caters to students with different learning preferences, fostering an inclusive and dynamic learning environment (Thanaphakawatkul et al., 2023). For this learning strategy, reflective elements must be incorporated into the case study discussions. This allows students to articulate their thoughts and learning processes, accommodating those who benefit from introspection and self-expression. As an educator, I also need to recognize that students may have different comfort levels with participation. I will offer alternatives, such as written reflections or individual assessments, for those who may prefer less verbal interaction. Next, I will develop assessment criteria that acknowledge and reward different contributions. The content of responses and the collaborative process will be assessed, encouraging recognition of diverse strengths within the learning community. Lastly, providing personalized feedback that considers individual learning styles and contributions is essential.

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13 This fosters a supportive learning environment where each student's strengths are recognized and reinforced (Thanaphakawatkul et al., 2023). By implementing the "Interactive Case Studies" learning strategy in this way, I aim to create a flexible and inclusive learning environment that caters to diverse learning needs. The emphasis on varied formats, group dynamics, and personalized feedback ensures that all students can actively engage with and benefit from the interactive case study approach. Assessment of Learning Needs and Styles The learning strategy described in the previous section, which focuses on "Interactive Case Studies" for the "Community Health Nursing Foundations" module, predominantly addresses the collaborative and interpersonal learning style. The emphasis on engaging students in group activities, discussions, and collaborative problem-solving caters to individuals who thrive in social and interactive learning environments. This aligns with the interpersonal learning style. Working together in groups allows interpersonal learners to exchange ideas, discuss concepts, and learn from one another through social interactions. The strategy encourages the development of effective communication and teamwork skills, which are essential aspects of collaborative learning environments that appeal to those with an interpersonal learning style. By incorporating interactive case studies focusing on group collaboration, the strategy aims to create a learning experience that resonates with individuals who prefer to learn through social engagement and interpersonal interactions (Thanaphakawatkul et al., 2023). Clinical Reasoning and Self-Reflection Skills The "Interactive Case Studies" learning strategy provides a rich environment for developing clinical reasoning and self-reflection skills. Through real-world application, collaborative problem-solving, and structured debriefing, students actively engage in learning,

14 enhancing their ability to think critically, make informed clinical decisions, and reflect on their evolving skills as future healthcare professionals. First, interactive case studies involve analyzing realistic scenarios, allowing students to apply theoretical knowledge to practical situations. This real-world application is essential for developing clinical reasoning skills as students learn to assess, analyze, and make decisions in contextually relevant situations (Horigan, n.d.). Group discussions and collaborative problem-solving within the case studies foster a dynamic exchange of ideas. Students can learn from different perspectives and develop their ability to identify problems, consider alternative solutions, and make informed decisions—a key component of clinical reasoning. The interactive nature of the case studies allows for immediate feedback and discussion. This facilitates a continuous cycle of learning and refinement of clinical reasoning skills, as students can assess the effectiveness of their thought processes in real time (Horigan, n.d.; Thanaphakawatkul et al., 2023). After completing case studies, incorporating dedicated time for group discussions and debriefing encourages self-reflection. Students can reflect on their contributions, decision- making processes, and the effectiveness of their collaborative efforts. Engaging in discussions about the case studies prompts students to think about their thinking, fostering metacognitive skills. This self-awareness is crucial for self-reflection as students consider how their thoughts, biases, and experiences influence their clinical reasoning and decision-making (Horigan, n.d.). Encouraging students to integrate feedback from peers and facilitators actively enhances their ability to self-reflect. By acknowledging different perspectives and considering alternative solutions, students develop a deeper understanding of their clinical reasoning processes (Berg & Lepp, 2023). Analyzing case studies and engaging in group discussions prompts students to think critically about the presented scenarios. Critical thinking is foundational to clinical reasoning,

15 and the strategy's reflective components encourage students to evaluate their thought processes systematically. Learning Environments There are various learning environments that are crucial to the development of a well- rounded student nurse who knows how to work in a team and collaborate with others to provide quality, patient-centered care. As an educator I will emphasize that working in a team is a crucial part of patient care as it brings together multiple professionals who discuss best practice treatment options. In a face-to-face environment, students learn to interact with peers, have discussions about various nursing issues and solutions, and collaborate with others. In this type of environment, as the educator, I can break the class into small groups and have each participate in a legislative session to advocate for certain policies. This type of environment will allow students to learn to collaborate and communicate together, putting the needs of the patient in the center of the discussion, and fosters teamwork amongst the class. In this sort of environment, the student is at the center of the learning experience, actively engaging in discussions and working with their teammates. In the online learning environment, I can create a virtual simulation where students actively engage in a patient care scenario. They will collaborate, taking on various healthcare roles, and work as a team communicating effectively to solve the virtual simulation. This group effort puts the students in the middle of their learning experience by immersing them in a virtual clinical scenario. Collaborative environments provide a platform for students to share their insights, experiences, and problem-solving skills. Team-based problem-solving is particularly valuable in simulated healthcare situations, allowing for a more comprehensive analysis and resolution of patient health issues. Virtual simulations allow students to practice teamwork and

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16 communication skills in a realistic online environment, fostering collaboration in a remote setting. Lastly, in a clinical setting I can conduct debriefing sessions after clinical experiences to discuss teamwork, communication, and challenges encountered. The clinical setting will allow students to apply theoretical knowledge into the real-world. The educator can open the session with open-ended questions, such as asking about the teamwork dynamic that the students observed in the process of sending a patient to a skilled nursing facility. These debriefing sessions will place students at the center of the discussions and allow them to reflect on teamwork and collaboration. This will help build their experience in understanding the importance of teamwork and enhance students' ability to integrate interprofessional perspectives, leading to more comprehensive and patient-centered care. Students learn that collaborative efforts foster open communication among healthcare team members, reducing the risk of misunderstandings and promoting a shared understanding of patient needs. Nursing Students’ Experiences The cultural, societal, and life experiences of nursing students play a significant role in shaping their abilities to learn. According to Vygotsky's sociocultural theory, learning is a social activity that is deeply influenced by cultural contexts. Cultural backgrounds shape students' cognitive processes, communication styles, and problem-solving approaches (McLeod, 2023). For example, a student may come from a family that spoke a different language when they were growing up. This may influence the students’ ability to speak up in class and ask questions. It is important to identify learning barriers for these students to make education equitable. Brion (2021) talks about the importance of including cultures during teaching in order to create trusting relationships with the students. He says that students’ whose culture is not included in the

17 teaching experience feel isolated and, again, are less likely to make relationships and have a meaningful learning experience (Brion, 2021). Social determinants of health encompass economic, social, and environmental factors that significantly influence health outcomes. These determinants also impact access to education and learning resources for these students. Students who face socioeconomic challenges in life may encounter difficulties accessing educational materials, technology, or external support systems. Also, students who grew up in a strict household, may work at a more vigorous pace and expect a lot from themselves. This societal influence from the parents can affect the student’s work ethic (Chan et al., 2019). In a student’s personal life, many factors can influence the student’s ability to not only learn but form positive relationships. For example, students who grew up in households that were not secure, such as subject to abuse, may not form relationships quickly, or have a quick motivation to trust someone. This can greatly impact their ability to learn to work in a team, which is a crucial part of the healthcare environment (Lloyd, 2018). Memories also play crucial roles in the way students perceive later life experiences, as they will draw from previous knowledge. Educators need to be sensitive when talking about certain topics during lecture, such as mental health, cancer, and surgeries, as students may have memories, good or bad, associated with those topics. This can greatly impact the way they receive and learn this information (Chuqi Liu, 2022). Understanding these societal factors and experiences in the lives of students is crucial for educators to provide targeted assistance and create an inclusive learning environment. Learning Theories The principles behind the constructivist learning theory include active participation, social interaction, meaningful context, and reflection. Learners in active participation construct knowledge through hands-on experiences and engagement with the learning material.

18 Collaborative learning and interaction with peers and instructors are the principles of social interaction that play a vital role in knowledge construction. Learning is most effective when situated in a meaningful context, allowing learners to connect new information to existing knowledge. Lastly, reflection on experiences and ongoing feedback contribute to refining understanding and knowledge construction (Epp et al., 2021). This learning theory can be applied to a nursing education course in multiple ways. First, an educator can promote active participation by designing case studies that mirror real-world nursing scenarios, requiring students to apply theoretical knowledge to solve complex problems actively. Constructivism emphasizes learning through problem-solving and real-world application. Case-based learning encourages students to engage in critical thinking actively, draw connections between theory and practice, and construct their understanding of nursing principles in clinical contexts. For the social interaction principle, the educator can incorporate group projects, peer discussions, and collaborative activities where students work together to solve problems or address healthcare challenges. Engaging in collaborative learning activities allows nursing students to share perspectives, learn from each other's experiences, and collectively construct knowledge in a supportive environment (Epp et al., 2021). The next principle of the constructivist learning theory is meaningful context. This can be applied to a nursing course by creating realistic simulation exercises replicating clinical scenarios, requiring students to make decisions, apply nursing interventions, and adapt to dynamic situations. Simulations provide a controlled yet authentic environment for active learning. Students engage in hands-on experiences that mirror clinical practice, promoting the construction of knowledge through experiential learning and providing a meaningful context for students to use their nursing skills. The last principle of constructivism is reflection. An educator

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19 can implement this principle by allowing students to participate in reflective journaling assignments where students document and analyze their clinical experiences, challenges, and growth throughout the course. Reflective practices are central to constructivism. Journaling encourages students to reflect on their actions, identify patterns in their learning, and refine their understanding, contributing to the ongoing construction of knowledge (Epp et al., 2021).

20 References American Association of Colleges of Nursing (AACN). (2008). The essentials of baccalaureate education for professional nursing practice . https://www.aacnnursing.org/portals/42/publications/baccessentials08.pdf Berg, E., & Lepp, M. (2023). The meaning and application of student-centered learning in nursing education: An integrative review of the literature. Nurse Education in Practice, 69 , 103622. https://doi.org/10.1016/j.nepr.2023.103622 Brion, C. (2021). Culture impacts learning-and not just for students. The Learning Professional, 42 (1). https://learningforward.org/wp-content/uploads/2021/02/culture-impacts-learning- and-not-just-for-students.pdf Chan, D., Lo, K., & Cheung, F. (2019). Social influences of teachers, classmates, and parents. Int Arch Public Health Community Med 3 (28). doi.org/10.23937/2643-4512/1710028 Chuqi Liu, G. (2022). Memory: Associating the old with the new. eLife. https://doi.org/10.7554/eLife.80030 Epp, S., Reekie, M., Denison, J., De Bosch Kemper, N., Willson, M., & Marck, P. (2021). Radical transformation: Embracing constructivism and pedagogy for an innovative nursing curriculum. Journal of Professional Nursing, 37 (5), 804-809. https://doi.org/10.1016/j.profnurs.2021.06.007 Horigan, A. (n.d.). Teaching with case studies to develop clinical reasoning . Emory University. https://cfde.emory.edu/resources/teaching-pedagogy/case-studies.html#:~:text=Enables %20students%20to%20practice%20making,dots%20between%20theory%20and %20practice .

21 Kalu, F., Wolsey, C., & Enghiad, P. (2023). Undergraduate nursing students' perceptions of active learning strategies: A focus group study. Nurse Education Today, 131 , 105986. https://doi.org/10.1016/j.nedt.2023.105986 Leyva-Moral, J. M., Tosun, B., Gómez-Ibáñez, R., Navarrete, L., Yava, A., Aguayo-González, M., Dirgar, E., Checa-Jiménez, C., & Bernabeu-Tamayo, M. D. (2023). From a learning opportunity to a conscious multidimensional change: a metasynthesis of transcultural learning experiences among nursing students. BMC Nursing, 22 (1), 1–15. https://doi.org/10.1186/s12912-023-01521-4 Lloyd M. (2018). Domestic violence and education: Examining the impact of domestic violence on young children, children, and young people and the potential role of schools. Frontiers in psychology, 9 , 2094. https://doi.org/10.3389/fpsyg.2018.02094 McLeod, S. (2023). Lev vygotsky’s sociocultural learning theory. https://www.simplypsychology.org/vygotsky.html Thanaphakawatkul, C., Ayudhaya, P, I., & Pusopa, C. (2023). Learning outcomes aligned with thai qualifications framework for higher education in nursing students. International Online Journal of Education & Teaching, 10 (3), (pp. 2190–2200). https://eds.s.ebscohost.com/eds/pdfviewer/pdfviewer?vid=5&sid=62320743-5652-4fa7- bd85-223d3b26c753%40redis

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C919 essay 2.0

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