How to Use a Patient Blog to Teach Empathy in a Nursing Flipped Classroom
A patient blog can be rich with opportunities to learn about a disease's emotional, spiritual, and psychosocial complications.
Let's start at the beginning: what is a blog? A blog is simply a website that an individual or small group writes. It is written in an informal, informative style and allows the writer to connect with the reader by sharing. You are reading a blog right now! I have always felt weird about the word blog (maybe that's part of my Generation Y upbringing and the slight discomfort I still have with technology), so I named this place the Idea Bank. But at its core, it is a blog; I shouldn't deny that any longer.
Why use a blog? Isn’t that for influencers?
A blog is a common communication tool for patients. CaringBridge is a website dedicated to documenting personal health journeys. It was started in 1997 when a set of new parents asked their friend, a software engineer, to keep their family and friends updated on the health journey of their daughter, who was born prematurely. Since then, it has grown as a way to document a healthcare journey.
A blog's informal style and easy accessibility make it a prime location for sharing a medical journey. Patients may start writing to communicate with far-away family members, share their experiences with others with the same condition, or as a kind of cathartic journaling about their illness. For nurse educators, these online, diary-like entries can be an excellent place for students to practice the therapeutic communication skill of listening.
**CaringBridge has privacy settings, allowing authors to determine who can access their journals.**
I believe we can teach students empathy, but we must be intentional about presenting these opportunities. For another idea about how to teach caring in the classroom, check out the Empathy Map.
Getting started using a patient blog to teach active listening
Start by choosing a classroom topic. I started using this activity in my classroom session on leukemia and lymphoma. For this content, we focused on basic pathophysiology, chemotherapy complications, and oncological emergencies. However, I felt like it was missing the emotional, spiritual, and relationship components related to the care of the oncological patient.
Let the students locate the blog. They are expert internet searchers, and I have never had an issue with a student unable to locate a patient blog. You can add variety to your assignments; for example, I would assign adult leukemia, pediatric leukemia, adult lymphoma, and pediatric lymphoma to different groups, which allowed me to add lifespan considerations to the discussion.
Give students a framework
Assign students to complete the "Blog Investigation" Worksheet. You can download this template here and modify it as needed. This activity aims to highlight the psychosocial aspects of nursing care, so feel free to include areas where you see students struggle. The investigation can occur during class, as part of a group, or individually as a prework assignment. Below is an example of a blank worksheet.
Getting at the deeper learning
Group discussion helps debrief this nursing flipped classroom activity. Consider putting students in small groups, each having researched and read about a different condition (think one adult leukemia, one pediatric lymphoma, etc.). You could also use a large group discussion format.
The deep learning for this activity comes when the instructor can connect this worksheet to nursing theory. Have students create a care plan (using your school's care plan paperwork—no need to reinvent the wheel) for the patient they encounter in the blog. You can also use this care planning template.
Pull out assessment findings that the patient writes about (skin changes, hair loss, lab value abnormalities, mucositis) and use them to identify a priority problem with appropriate nursing interventions. Discuss medications, medical management, therapies, and dietary consideration. Try to incorporate interdisciplinary team members. Finally, ask questions about how the students could show empathy and care towards this patient or their family.
One aspect that is great about this activity is that patients' experiences are so varied. Some have excellent care, respond to treatment, and follow up as outpatients. On the other hand, some journeys are full of complications. Sometimes, a patient may die. However, these are all outcomes that nurses can and should plan for in patient care.
This nursing flipped classroom activity will take about 20-30 minutes for discussion and care plan development.
Where can this flipped classroom activity be used?
This nursing flipped classroom activity works best when teaching conditions with high psychosocial complications. Any oncology content, chronic conditions like diabetes, or long-term disease processes works best when looking for a blog. For example, patients will not blog about their cholecystectomy or tonsillectomy because it is acute and resolved in a few days.
Variations - Clinical Option
Using a patient blog can be a great alternative to a slow clinical day. I know - slow clinical days are as rare as unicorns, but you may encounter downtime depending on the unit or the census.
Assign students to locate a blog and complete the worksheet for a blogger with the same condition as the patient they are caring for in clinical that day. For example, if you assign an elderly patient with CHF exacerbation, instruct the student to find a blog for a pediatric patient with CHF due to a congenital abnormality.
Next, have the student compare and contrast these patients. What pathophysiology is the same? What assessment findings are different? Is weight still important to monitor? What medications are each taking, and how much? This activity helps students scaffold their knowledge and build their ability to care for various patients. They have a foundation of CHF knowledge in their brains; now, they are constructing a little staircase that connects that foundation to a new room that houses their pediatric knowledge.
Once the activity is complete, have students share their compare-and-contrast findings in the post-conference.
Start Using a Patient Blog to Teach Caring and Active Listening
A patient blog can give nursing students an interesting perspective as they go through an illness. Start by choosing a content topic with high psychosocial impact, such as a chronic condition. Next, use the "Research a Blog" worksheet as a template that gives students a framework as they work through the blog. Finally, the activity will be debriefed, and the patient's experience will be connected to nursing theory by connecting pathophysiology, pharmacology, and care planning.
Remember, you can start transforming your classroom with a simple activity. You do not have to change it all between semesters. Just slowly add one activity at a time!