Dara Yastrzemski

SUNY Delhi
NURS601
Summer 2016
Dr. Digger
Designing a Lesson Plan
Part A
June 25, 2016

Curriculum: Perioperative RN Training

Course: Perioperative Nursing: Orthopedic Procedures
Topic: Hana Table for Anterior Approach Total Hip Replacement
Setting: Classroom, face-to-face, hospital

Hana Table for Anterior Approach Total Hip Replacement

Module Description:
This course will comprise of the following skills:

Identify and Interview the Patient

Assist Anesthesia with Sign In and Intubation
Positioning Patient on Hana Table

Learning Objectives:
The student will be able to demonstrate, identify, and obtain a working knowledge of
perioperative room set-up. These objectives will be measurable as evidence by student outcomes
in the following:

Exams
Direct Observations

Timeline: June 6th-July 5th, 2016.

Each learning module will be discussed and reviewed for approximately 1-2 hours.
Learning Module Content:
Reading for Week 1
The Perioperative Nurses Role in Table-Enhanced Anterior Total Hip Arthroplasty.
Cassendra A. Munro, RN MSN, CNOR
http://www.aornjournal.org/article/S0001-2092(09)00170-7/pdf
Exam to follow reading.

Anterior muscle sparing approach for total hip arthroplasty.

Joseph T Moskal, Susan G Capps, and John A Scanelli
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3557317/ Exam to follow reading.
Comparison of primary total hip replacements performed with a direct
anterior approach versus the standard lateral approach: perioperative
findings.
Vincenzo Alecci, Maurizio Valente, Marina Crucil, Matteo Minerva, Chiara-Martina
Pellegrino, and Dario Davide Sabbadini
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3163771/ Exam to follow reading.
Webinar for Week 1
https://www.youtube.com/watch?v=6-zLu_eq8MI
Shadowing for Weeks 1 & 2
Each experience will take place in the operating room and will last approximately 2 hours and
will conclude with a debriefing discussion. Direct observation with debriefing to follow.
Practice Simulation for Week 3
Practice simulations will be scheduled on the following dates, 6/20, 6/22, & 6/23 (date and time
to be assigned to each student). Practice sessions should last 60 minutes. Instruction to be taught
by staff RNs in the operating room. Meet with teacher afterward for discussion.
Preceptor on Perioperative Unit for Week 4
Staff RNs will act as preceptor. Debriefing and further instruction to follow each OR day with
the teacher.
Teaching Strategies and Measurement of Learning Objectives:
When developing teaching strategies, it is important to focus on what type of learner the student
is. In designing this learning lesson, I identified different ways to teach each goal. The student
will explain and demonstrate how to identify and interview the patient prior to surgery. The

student will safely and effectively using evidence based practice to assist anesthesia with sign in
and intubation. The student will safely demonstrate how to assist with positioning the patient on
the Hana table. Evaluation of the lesson plan will be ongoing and adjustments will be made to
facilitate the learner. All feedback will be used as a continual process to reflect and capture
learning needs to assist with the continual improvement of competency.

Hana Table for Anterior Approach Total Hip Replacement

This lesson was designed for the new nurse on the perioperative unit. The lesson plan focuses on
the safety of the patient and positive outcomes for the patient, before, during, and after the
procedure.

Learning Plan Objectives and Bloom's Taxonomy

Read the provided journal articles about the anterior approach for total hip replacement.
Complete the CE exam at the end of the Munro article. Students will be able to identify

the benefits and risks of the anterior approach (Remembering/Understanding).

Watch a webinar of the positioning and components needed for the Hana table. Students

will be able to prepare the equipment for surgical procedure (Understanding/Applying).

Shadow a colleague. Students will be able to gather information through observation of

procedure (Evaluating).
Practice simulation. Students will demonstrate how to operate the equipment

(Remembering/Understanding/Applying).
Actively participate in a case with a preceptor. Students will demonstrate their knowledge
of the equipment, procedure, safety, and patient outcomes
(Remembering/Understanding/Applying/Creating) (Huitt, 2011).

These objectives will help guide the students by building their knowledge base prior to
exposure to an actual case in the operating room. It has been the past practice to place new
nurses in the procedure without any formal instruction. This was often met with fear and
many new nurses felt vulnerable and unsupported. Retention was weak and it was decided to
revamp the training of new perioperative nurse. Upon evaluation, new nurses have stated
they feel overwhelmed and intimidated by the complex information needed to successfully
circulate during a procedure. Guiding new nurses should be a step-by-step process that
includes time for reflection on the materials learned and the experiences that are witnessed in
the operating room. The learning objectives for for this module will assist the students to
move through their education in a more formal manner. It is also the goal of the instructor to
adjust as needed throughout the process in order to better meet the needs of the individual
student learner.
Timeframe for Learning Module
The perioperative arena is a complex area that is unfamiliar to most nurses. Perioperative
nursing is a specialty that requires time. Training can be from 10 months to 18 months before
a nurse is qualified to circulate a case without the aid of a preceptor. This learning module
will take approximately 4 weeks to incorporate all the information needed for the student to
demonstrate independent practice.
Teaching Strategies
In this lesson module there are several different types of teaching strategies utilized. The
strategies begin with teacher-centered instruction and move to learner-centered experiences.
This type of learner-centered instruction empowers students with control over their own
learning process, encourages collaboration and promotes reflection on learning (Billings &

Halstead, 2016). This class will meet in traditional classroom setting with lecture. The class
will then move on to an online format in the viewing of video. The remainder of the course
will be based on active learning and application of knowledge. Potential barriers to the
chosen teaching strategies could include time constraints. There are often delays or
cancelations in the operating room that are unavoidable. Other barriers could include
resources, such as equipment failure or implant contamination. In both cases, the procedure
would be cancelled. The timeframe would have to be flexible to allow for these types of
constraints.

Learner-Centered Teaching
In her article about the five characteristics of learner-centered teaching, Maryellen Weimer
(2012) asks the question of what really makes teaching "learner-centered". Weimer believes
teachers do too much for students and encourage more students to practice in the act of learning
(2012). In the perioperative setting, the past training experience was one where the student was
exposed to a situation without the benefit of what to expect. In learner-centered education, the
student builds on their foundation of skills and learns to collaborate, control, and reflect on their
learning experiences. It is important for new perioperative nurses to be able to problem solve,
evaluate and analyze. These are skills that need to be taught. It is the goal of this learning module
to prepare the nurse student to develop these skills.

References

Alecci, V., Valente, M., Crucil, M., Minerva, M., Pellegrino, C.M., & Davide, D. (2011).
Comparison of primary total hip replacements performed with a direct anterior approach
versus the standard lateral approach: Perioperative findings. Journal of Orthopaedics and
Traumatology. 12(3). 123-129. doi: 10.1007/s10195-011-0144-0
Hunter, M. (n.d.). The Madeline Hunter Model of Mastery Learning. Retrieved from
http://www.onetohio.org/library/Documents/Dr%20Madeline%20Hunter%20Article1.pdf
Moskal, J.T., Capps, S., & Scanelli, J.A. (2013). Anterior muscle sparing approach for total hip
arthroplasty. World Journal of Orthopedics. 4(1). 12-18. doi: 10.5312/wjo.v4.i1.12
Munro, C.A. (2009). The perioperative nurse's role in table-enhanced anterior total hip
arthroplasty. Association of Perioperative Registered Nurses. 90(1). Retrieved from
http://www.aornjournal.org/article/S0001-2092(09)00170-7/pdf
Swedes Periop Education Videos. (2014). Hana table. Retrieved from
https://www.youtube.com/watch?v=6-zLu_eq8MI