by June Kaminski, RN MSN PhD(c)
CJNI Editor in Chief
This paper was presented at the HETL Conference in
Anchorage, Alaska in June 2014
This conceptual paper focuses on the implementation of a diverse technological landscape within a blended post-baccalaureate nursing program (BSN-PB) in Western Canada. The challenge of nurturing nursing students within a blended program demands innovative and engaged activities and assignments. The development of a rich robust technological e-scape for nursing education requires intense planning and the application of diverse programs and applications. The BSN-PB program incorporates multiple technological layers to shape the e-scape for students, metaphorically similar to the intricate organization of a healthy food forest garden.
When designing a food forest garden, plants are selected that create a food web and guild structure that works together to form a rigorous closed ecosystem. Everything grown in this type of forest is edible and sustainable. Similarly, various layers of technology that interact within the learning e-scape can be applied to create a rich learning ecosystem that nourishes the development of nursing knowledge, competencies, skills, and culture within the blended environment. Seven major technological layers were carefully selected to enrich student learning within the BSN-PB program. This analysis presents these layers within a food forest garden analogy to introduce how a variety of technological innovations can be seamlessly applied to enrich and shape reflective and dynamic learning.
Food forest gardens are a form of permaculture or agroforestry (Hart, 1996), and result from deliberate cultivation of various cohabiting and edible trees, shrubs, plants, vines, and ground cover plants. The practice has thrived in tropical countries for centuries but is considered unique in the realm of Western agriculture. Typically, Robert Hart is lauded as the key pioneer of forest gardens in temperate climate countries. Hart credits James Sholto Douglas’ work with forest farming in South Africa for introducing him to the notion, after years of struggling to make a conventional small farm productive. Both Douglas and Hart (1976) credited Toyohiko Kagawa’s work with three dimensional forest gardens in the Japanese mountains as inspiration. Douglas worked with Kagawa in Japan to learn his system, and applied the principles in his own South African location (Hart, 1996).
After reading Douglas’ article, Robert Hart began to experiment with hedge and herbaceous cultivation intended for livestock feed and soil preservation (Hart, 1996). He planted hedges such as wild roses and hazelnuts plus herbaceous plants such as chicory and yarrow. He then decided to plant food bearing trees and other plants to feed his family and support self – sufficiency. This experimentation led him to identify seven layers of compatible and synergistic plants that could be cultivated together, to develop into an ecosystem of nutritional sources that required very little human intervention to flourish. According to Hart, a one acre plot can feed up to ten people well with a variety of foods, if planted carefully and knowledgeably.
Food forests are incredibly sustainable and are lauded as the answer to the deforestation, concrete jungle approach of modern life. Not only do they provide healthy, life-sustaining foods, but they also attract and harbour wildlife and birds, support and enrich the soil, add beauty and sanctuary to the human environment and reduce the toil and energy needed to take care of oneself and one’s family. The careful initial planning, planting and cultivation reaps rich rewards of organic, nutrient dense food, available immediately at little cost, and with little ongoing effort. Hart (1996) stressed that perennial plants were a key to his food forest garden success. Over the years Hart planted over seventy species of plants, all edible and all self-sustaining except for occasional trimming and mulching.
The placement and synergy between the plants produce very favorable and critical characteristics that ensure their success and sustainability. “Forest gardeners use the forest as a design metaphor, a model of structure and function, while adapting the design to focus on meeting human needs in a small space.” (Jacke & Toensmeier, 2005a, p. 2).
Seven food forest garden characteristics were identified by Robert Hart (1996) who wrote they are:
These characteristics support conditions for sustenance and long-term health as well as economic benefits. Forest gardens also support environmental vitality since they can help to sustain and protect animals, birds, pollinating insects, and improve the oxygen of the air, and nitrogen of the soil. “The goal of the forest gardener is to follow these patterns and establish a perennial polyculture from which food is harvested with minimal disturbance” (Ussery, 2007, p. 97).
Ron Berezan (2010) followed Robert Hart’s example and experimented with food forests in Western Canada. He reinforced the premise that food forests are designed to develop following the same principles seen in natural forests. “One of the core principles articulated well by Robert Hart is that forest architecture is typically multi-layered with a variety of plants occupying niches at different heights: tall trees, small trees, shrubs, herbaceous perennials, ground covers, vining plants and the root zone. There is a careful selection and placement of all species such that functional communities, or guilds, of plants that support each other are created.” (p. 19).
Often the disciples of forest gardens, including Robert Hart shared their experiences of shaping such gardens in very philosophical ways. They wrote that forest gardens are not just a practice, but a way of life, a way to demonstrate the interconnectedness of life and nature, and a way to give back to the planet that sustains us. “The ultimate goal of forest gardening is not only the growing of crops, but also the cultivation and perfection of new ways of seeing, of thinking, and acting in the world.” (Jacke & Toensmeier, 2005a, p. 9).
An ecological perspective underlines the premise of forest gardens. According to Jacke and Toensmeier, 2005a). Key elements of this perspective include:
While searching for an appropriate metaphor to describe the rigorous process used to integrate technology into the BSN-PB program, the notion of food forest gardens eventually came to mind. The careful planning and selection necessary to design and cultivate a food forest garden appeared to perfectly serve as a model for the deliberate and methodical approach taken to select these technologies. The seven layers of food forest gardens described by Robert Hart (1996) provided a usable model to represent the seven layers of technology adopted by the program.
This section presents this metaphoric comparison with a layer by layer analysis, as summarized in Table 1.
The canopy or overstory layer of a food forest garden consists of large (over 12 feet high) fruit or nut bearing trees. Examples of canopy trees include chestnut, persimmons, cherry, pecan, walnut, carob, quince, apple and pear trees. These trees form a crown of protective, shading boughs that consistently access sun rays, photosynthesize, and provide oxygen and other nutrients to the environment around them. They protect the lower layers of the forest from heavy precipitation and winds, and provide perfect living conditions for a variety of birds and other wildlife. (Jacke & Toensmeier, 2005a; Hart, 1996). The shape of the canopy trees also determines how precipitation reaches the lower layers (for instance whether the rain runs along its branches or down the trunk). As well, the falling leaves from the canopy provide important nutrients such as nitrogen to the plants below.
“The canopy is a complex structure that provides a surface for wet, dry and cloud water deposition of mineral nutrients from the atmosphere, and the type of structure can influence the rate of deposition. The biotic features of the forest canopy function to capture, transform, and cycle nutrients within the canopy as a complex and independent subsystem of the whole forest” (Shaw & Bible, 1996, p. 2.) When viewed from a distance, the canopy is usually the first layer that is visible or noticed. It is a distinctive layer that all other layers benefit from.
In the BSN-PB program, the Moodle (Modular Object Oriented Developmental Learning Environment) Learning Management System (LMS) is the central technological layer. All of the program course content is presented using Moodle, providing an overstory layer of content and interaction.“Moodle is an open source LCMS application (learning content management system) based on the didactic principle of constructivism. In Moodle learners construct their individual learning situation by interacting with educational material provided by teachers.” (Rákóczi & Pohl, 2009, p. 467). The Moodle system is a very sophisticated LMS that affords a variety of learning modules that teachers can use to engage with students, including forums, wikis, journals, uploaded assignments, group work, chat rooms, workshops, lessons, polls, databases, glossaries, quizzes, SCORM and IMS packages, surveys, and Lightbox galleries. Content can be organized as pages and books with added files, folders and web links. This versatility provides a malleable canopy or overstory of activities that supports the structure and content of the program well.
Moodle is also the central access point for grading and assessment in the program and provides linkages and guides on how to use the other technological layers used by students. For instance, Voice Thread activities (housed on the Voicethread web site) are seamlessly accessed through a Moodle plugin. Mahara eportfolios can also be accessed through a Moodle plugin. Allocated readings in electronic textbooks and resource access directives are all presented in Moodle using a book activity layout (see Figure 2). The four graphic ‘doors’ lead the students to each week’s course learning activity, organized in chunks (Moore, 2012) within the headings of Situating, Preparing, Engaging, and Reflecting.
The “Situating” book section provides an overview of each learning activity’s content topic as well as the outcomes for the week’s lesson. The “Preparing” book section outlines the required readings and other activities such as videos to watch or online resources to access. The “Engaging” section provides detailed directions on the required activities for that week, including iPad and app activities such as creating visual models, designing teaching materials, accessing lifestyle and nutrition apps or ibooks and so on. This is also the section where SIMs lab directives, practice guides or Mahara activity directives are provided. Finally, the “Reflecting” book section provides questions related to the learning activity content for students to reflect upon and digest.
Within these four sections, various activities are engaged in that follow the Moodle philosophy of social constructivism. “Social constructivism extends constructivism into social settings, wherein groups construct knowledge for one another, collaboratively creating a small culture of shared artifacts with shared meanings. When one is immersed within a culture like this, one is learning all the time about how to be a part of that culture, on many levels.” (Moodle 2.4 Philosophy, 2012).
As well, the Moodle course sites provide access to other important documents and information to support smooth course functioning. These include a downloadable syllabus of the course content (in case of technological glitches or failure), course outlines, rubrics for assessment, assignment details, and a student question forum for interaction with the assigned faculty.
Moodle is easy for students to use and can be accessed using any web browser (Amaral & de Almeida, 2009). “The most favourable thing students highlighted is the accessibility of available teaching material and exercises from virtually anywhere without geographical restrictions. Other benefits they highlighted are collection of all the teaching material in one place and the possibility of being informed about important issues regarding the courses they attend, such as grading changes and availability of the teaching material. This functionality is provided through Moodle’s integrated mailing services tightly connected to discussion forums” (Hölbl & Welzer, 2010, p.65).
The Moodle system can be seen as the canopy of the technological e-scape designed for the BSN-PB program since it is the most visible and accessed part of the escape, providing linkages and guidelines to using all seven of the technological layers. It provides a central enfolding core for the program due to its versatility, diverse activities, institutional support, and consistent visual interface. Although some programs might decide that Moodle provided enough technological access and support, the author and others involved in the program design decided that this was just the beginning for the BSN-PB program. Other technologies were needed to augment interaction, communication, creativity, and online learning experiences. Hence, Moodle was viewed as the central core or canopy of the e-scape that would work well with other layers of required technology.
The subcanopy is the first understory layer of food forest gardens which includes second-magnitude smaller fruit, nut or other edible trees, for instance bamboo, pea trees, apricot, olive, small plum and cherry, serviceberry, and crab apple. The subcanopy is situated right below the canopy trees meaning it receives less sunlight than the canopy but more light than the five lower layers. This diminished light often keeps this layer of trees smaller than the overshadowing canopy trees. This layer also provides protection from inclement weather, sheds its leaves to aid in mulching and nitrogen building, and provides more accessible food and shelter to humans, birds, and wildlife (Hart, 1996).
Mahara is the second most prolifically used technology in the BSN-PB program, thus is metaphorically represented in this paper with the subcanopy of a food forest garden (see Figure 3). Mahara is an open source, ePortfolio system that supports a personalized learning environment. Mahara was selected to be a secondary learning system for the BSN-PB students to enhance learning in aesthetic, reflective and professional developmental ways. The ePortfolio is initiated in semester one of the program, and further developed throughout the seven semesters of the program. The ePortfolios are clustered according to cohort so that all student ePortfolios within a class are grouped together. As well, a mentor group has been set up in Mahara where students, faculty and assigned nurse mentors can engage together within the ePortfolio milieu.
In the BSN-PB program, Mahara ePortfolios are used as assessment, credential, learning and showcase portfolios (McAllister et al, 2008). Students complete a profile page with resume specific data and other personal information. They create collections of pages organized in semester clusters for ease of accessibility and organization. Over the seven semesters, learning artifacts are added to produce a robust repository of student work. These artifacts include aesthetic creative work, practice journals, case study analyses, and other assigned work. “The contents are selected, recorded, organised and presented in a meaningful way over time, to be used by the student in their reflective considerations, with tutors and peers where appropriate, and as a means for presenting themselves with greater depth and individual richness to others (e.g. research funders, potential employers). It is a place for constructing and telling myriad stories to diverse audiences” (O’Toole, 2013, p. 3).
The Mahara environment is easy to use and can display written work, art and visual models, galleries for assignments such as Photo Novellas, links to online work done in programs such as Educreations and Voice Thread, and uploaded files and videos. The Mahara interface uses a simple drag and drop approach to file integration enabling students to display their work aesthetically in a well-organized way.
One example of an aesthetic activity that is used in the BSN-PB program is outlined below.
Seven Grandfather Teachings for Nurses
Read the Seven Grandfather Teachings through a few times then use your Pages app to write a free verse that incorporates all seven teachings into a guide for nurses to relationally engage with clients.
Upload your work to your Mahara page.
Mahara is also used for practice and theory related reflection. Praxis is a key component of all seven practice courses in the program, where students practice with clients or in labs to master nursing skills, then engage in reflection-on-action, reflection-in-action, and reflection-for-action with their fellow classmates and faculty instructor. Dialogic journals are used frequently within Mahara to encourage critical and meaningful reflection by students, and responded to by faculty to encourage praxis reflection. An example of this reflection is provided in the activity below:
Talk with your mentor about their experience with legal – ethical considerations in client care. How did they cope with these dilemmas?
Reflect on this dialogue in your Mahara ePortfolio Journal.
Mahara provides an accessible and permanent space for students to reflect on work they have done using other technological layers, such as iPads and apps or SIMs lab practice. For instance, students are asked to use nutrition and fitness apps on their iPads in semester one, then reflect on their progress over time in their Mahara course page.
Mahara reinforces professional development, by helping students learn to use their profiles, resumes, achievements, and artifacts to promote nursing competencies and demonstrate life-long learning. Nurses are expected to engage in personal and professional development on an annual basis as part of licensure maintenance and renewal. The Mahara interface provides valuable practice to enable this ability post-graduation. Students have commented that seeing their work develop over each semester has given them a deeper appreciation of what they have learned and how they have developed over time. This awareness is invaluable for current and life-long learning. These software capabilities help reinforce the importance of Mahara to the program’s technological e-scape, much like the subcanopy plays an important role in the food forest garden.
The shrub layer of the food forest garden is a very productive and accessible layer. It serves as a sanctuary for birds and small animals, and often produces a rich assortment of berries and other edibles. Common shrub examples include blueberries, hazelnuts, raspberries, rose (hips) bushes, blackberries, and currants. Shrubs sometimes grow vertically, but due to shade and early mulching, they often spread horizontally beneath the outerstory. They also serve as overlay for smaller herbaceous and ground cover plants, and enrich the soil with their leaf and fruit droppings.
This horizontal growth seems to coincide with the horizontal interaction and engagement afforded by the use of social media such as blogs, wikis, YouTube and Voice Thread in the BSN-PB program (see Figure 4). “Social media encompass a wide range of tools that integrate technology, social interaction and content creation. In the present work, analysis will be confined to the most popular social media types. These include social networks, blogs, micro-blogs, wikis, bookmarking, media sharing and RSS” (Faizi, 2013, p. 50).
In the BSN-PB program, social media tools are mostly situated within the Moodle or Mahara layers through the use of social forums, friend lists, wikis, and sharing of work. The student engagement supported by these interactive tools adds a rich layer of social interaction and a sense of community. “Given the importance of collaboration in the learning process, a great number of social media tools serve as platforms for learners to gather and share information and resources from both internal and external collaboration networks” (Faizi, 2013, p. 52). Much like the shrub layers where animals big and small (bear, deer, squirrels, rabbits, and so on), birds, and people engage to enjoy the fruits and nuts and the protective aspects of the smaller plants, these software help to promote a sense of unity and engagement.
Software like VoiceThread is used in BSN-PB courses to promote multi-sensory ways to respond and reflect on course content (including audio, visual, and text). “A VoiceThread is a collaborative, multimedia slide show in which viewers navigate through the slides and leave comments. The comments can be left in five ways: using voice (with a telephone or a computer’s microphone), typing text, uploading an audio file, or creating video via a webcam” (Siegle, 2011, p. 56). In this nursing program the VoiceThread assignments are clustered within each course so students can access and contribute to each week’s VoiceThread as part of a collective experience. “So an entire classroom of students can collectively analyse a media text on a single page, share fresh perspectives, challenge each other’s thinking and develop greater understandings in the process.” (Rodesiler, 2010). BSN-PB students dialogue, reflect, analyze, present, and give feedback using VoiceThread. As students respond to assignments and comments left by other students, they practice expressive presentation and communication skills as they reflectively respond with voice or video recordings (Pecot-Hebert, 2012; Gillis et al, 2012).
Students also co-create content for weekly wikis where they upload and display their assigned work and then reflect on the work done by others. Comments and feedback are readily submitted using the wiki module in Moodle. An example of an activity that uses a wiki can be seen below:
Explore Plato’s concept of Societal Guardians and how this notion applies to the nursing profession. Express your exploration in some creative way: through an artistic visual or literary medium and upload your work to the Wiki
To date, social media platforms have mostly been used within protected mediums such as Mahara and Moodle in the BSN-PB program. This approach would equate to a carefully controlled yet thriving shrub layer in a food forest garden, where wildlife and people intermingle but growth is maintained within some structure and organizing pattern.
The herbaceous layer of the food forest garden colors the forest with bright perennial flowers and easy to access edible, culinary, and medicinal seeds, flowers, stems, leaves, and roots. This layer consists of soft- stemmed plants that wither and die back to the soil at the end of the growing season which provides rich mulch for the forest. However, most are perennials or self-propagating annuals so they continue to reproduce and grow again the following season. Examples of herbaceous plants include mints, rhubarb, asparagus, bee balm, comfrey, sage, nettles, burdock, chives, alfalfa, buckwheat, kale, sorrel, stevia and lemongrass.
Herbaceous plants adapt well and often flower early in the season before canopy leaves block out most of the light. This layer plays a significant role in supporting the vitality of the whole ecosystem, including the health of the soil. “Herbaceous plants greatly contribute to soil fertility by drawing nutrients out of the soil, storing them, and releasing them as they die. Some plants do this more actively than others, accumulating nutrients in their tissues to concentrations higher than those found in the soil or than usually found in the average plant. We can use these dynamic accumulators to conserve and improve soil fertility in our forest gardens”(Jacke & Toensmeier, 2005a, p. 186).
The herbaceous layer adds beauty and aesthetics to the food forest garden, as well as delightful edible foods, spices, and flavors. This layer seems to match well with the exciting technological additions afforded by the use of iPads and the many subject-specific, creative, productive, and exploratory apps available (see Figure 5). BSN-PB students purchase Apple iPads and apps in semester one and use them throughout the program for a variety of activities.
iPads and Apps are used in the BSN-PB program to:
Many of the weekly learning activities call for ipads to perform the hands-on aspects of the activities. Students use creative apps to ‘finger paint’ visual models; to produce desktop published tools such as teaching sheets, tip lists, brochures, and client education guides; create videos and other multimedia productions, and so on. The apps provide accessible tools to practice creating documents, tools, and models that help them understand the content being explored and apply to nursing practice.
For example, an activity that students do in semester two entails the following directive:
Caring for Older Adults Tip List
Use your Pages app to prepare a concise and usable tip list for nursing students about how to apply a therapeutic use of self and relational engagement to the care of older adult clients. Save your work as a pdf, png, or png and upload to Moodle and your Mahara course page.
The use of iPads also facilitates mobile learning (mlearning) where students can access course materials, readings, multimedia and other resources as well as apps from a variety of locations and contexts (Thinley et al, 2014; Pilgrim et al, 2012). This portability affords a freedom not provided from PC or laptop access alone. This free roaming aspect of learning is reminiscent of the freely propagated and spreading nature of herbaceous plants that stretch their stems and roots out to anchor themselves in new areas of soil. However, ipads are not just used as alternative delivery mediums in the BSN-PB program. They are used in creative and productive ways to enhance student learning, reflection and expression. Just as the herbaceous plants add aesthetics and resources to the ecosystem around them, so do iPads and apps enrich the learning experiences and capabilities of the students.
Mobile learning adds a level of flexibility, presence and engagement to learning that is often lacking (Kearney et al, 2012), and breaks down the barriers of time and space, since learning can be done anywhere. Kearney and his colleagues proposed a model that focused on “….personalisation, authenticity and collaboration as the three distinctive features of m-learning” (p. 8).
The rhizosphere layer of food forest gardens includes the edible root and tuber plants as well as other underground plant forms, including some fungi. Examples of rhizosphere plants include beetroot, carrots, arrowroot, garlic, potato, horseradish, ginger, onion and ginseng. Most of the important work of these plants occurs under the soil.
The rhizosphere is considered to be a very important layer of the food forest ecosystem. Besides providing edible roots, this layer is a critical factor for plant nutrition and soil integrity. “The plant root-soil interface is a dynamic region in which numerous biogeochemical processes take place driven by the physical activity, and the diversity of chemicals released by the plant root and mediated by soil microorganisms. In turn the processes occurring in this region control a host of reactions regulating terrestrial carbon and other element cycling that sustain plant growth and which have an enormous influence on plant and microbial community function and structure which greatly influence a variety of ecosystem level processes” (McNear, 2013, p. 1).
Like the rhizosphere forest layer, textbooks and supporting resources are critical tools for education (see Figure 6). The BSN-PB program uses electronic textbooks and online resources whenever possible, so that readings and practice activities can be done on the students’ computers and ipads. This facilitates access to readings from anywhere when using the mobile technology, including practice areas (hospitals, community, and so on). Students have access to resources at their fingertips, without having to carry huge nursing textbooks to their clinical practice areas (Parsons, 2014). Medication and pathophysiology reference materials are also readily available on their iPads (Williams & Dittmer, 2009). Electronic textbooks tend to cost less than printed books, they are more ecologically sound, (Gattiker et al, 2012) and they are easy to download (Swilley, 2012; Stone & Baker-Eveleth, 2013; Murray & Pérez, 2011). Another important bonus of e-textbooks is the ability to annotate the textbook directly on the device. When done on an iPad, this annotation can be done easily with the tip of a finger (Kim et al, 2013).
“Tablet technology has entered the classroom through devices such as the iPad. Instead of opening a bound textbook for class, students access digital textbooks and resources that contain interactive media and provide immediate feedback. The content is the same as a textbook, but the layout and pictures go beyond static images. Colorful, interactive diagrams, photos, and videos fill the screen. Students can explore and manipulate a 3-D picture of the human brain or enlarge text and photos. The tablet allows students to highlight text, take notes, and navigate through text by sliding a finger along the bottom of the screen. These intuitive, interactive features are appealing to students,” (Pilgrim et al, 2012, p. 17).
The ground cover layer of food forest gardens hugs the soil surface and is instrumental in collecting and redistributing nutrients from other layers. Often ground cover plants are creepers, since they spread their stems and branches horizontally along the ground. Examples of ground cover plants include strawberries, nasturtiums, wintergreen, clover, violets, vervain, cumin, and low bush blueberries. These are resilient plants that withstand the lowest level of light, and tend to fill in any bare patches on the forest floor. Robert Hart (1996) also includes edible mushrooms and ground growing fungi in this layer. This layer plays critical roles in protecting and enriching the soil, and providing easy to reach edible foods.
Like ground cover plants, Simulation Labs (SIMs) are a critical part of nursing education (see Figure 7). These technologically enhanced labs provide concrete “real-life like” practice in nursing skills and techniques in the safety of a lab setting. Students can practice and perfect complex procedures before performing them on actual clients. In the BSN-PB program, students practice regularly in carefully constructed SIMs labs. “Simulation provides students a chance to develop clinical judgment and affords faculty an opportunity to observe students’ clinical decision making and practice in a confined, prescribed setting. Role-playing, case scenarios, static manikins, and simulation are educational strategies believed to provide a vital bridge to practice that increases confidence and procedural proficiency” (Mikasa, 2013, p. e362).
BSN-PB Students often work in pairs and utilize their iPads to record their SIMs performance for reflective review. Each partner records the other’s performance on their own iPad, so they can go home and review their actions. The ability of the iPad to easily record a video of each student’s performance is a priceless bonus of using the mobile devices in this program. The ability to review one’s own actions by watching a recording rather than just from memory promotes confidence and provides valuable remedial evidence and direction for improvement (Foronda et al, 2013; Megel et al, 2013).
Electronically enhanced high-fidelity mannequins are used in the SIMs labs for role playing and practicing various skills including wound care, mental health crises, childbirth labor and delivery, (Sittner et al, 2013), trauma interventions and so on. These mannequins can simulate bleeding, breathing, heart rate, and other common physiological processes. “The more realistic (or immersive) the setup, the more students are likely to ‘buy in’ psychologically and experience deep, transformative learning” (Green & Bull, 2014, p. e111). Our program’s SIMs experts set up scenarios that are very realistic: for instance they equip a mannequin to resemble a motor vehicle accident victim requiring quick action and complex care. Faculty can monitor the student performance at the lab bedside or from within the SIMs control booth. This booth has screens to show a video of the actual bedside performance (Megel et al, 2013) as well as an electronic control screen where the mannequin’s breathing rate, and so on can be modulated and changed in response to students’ simulated care.
SIMs labs are available in our institution to mimic hospital care as well as home/community care. One lab is equipped to resemble a client’s home where the mannequin can be positioned in a bed, an arm chair, a couch, kitchen or bathroom. This latter lab helps students prepare for community health nursing practice (Distelhorst & Wyss, 2013). “Simulated community spaces provide an authentic learning environment that supports reflection, critical thinking, and confidence development, regardless of the clinical environment (Green & Bull, 2014, p. e112). Students learn more than just hands-on care: “Communication skills, knowledge of the nursing process, basic documentation and appropriate use of the patient record, and medical math calculations related to safe nursing practice are also included” (Greenawald, 2008, p. e11).
One important outcome of the SIMs lab is the students’ reported anxiety relief from practicing in the lab before trying to work with clients in practice settings (Lehr & Kaplan, 2013). “The outcomes that may result from simulation inclusion in an undergraduate nursing program include diminished anxiety, increased knowledge retention, and development of psychomotor skills before encountering the reality of acute care settings” (Stroup, 2014, p. e155). The SIMs lab helps the students feel safer and more comfortable and ‘protected’, just like the ground cover protects the forest soil and floor.
As well, SIMs labs provide opportunities to practice the complexity of nursing. “Nursing is holistic and multidimensional; insertion of a Foley catheter includes much more than just the psychomotor skill of insertion of the catheter. There are additional components to catheter insertion, such as establishing rapport, protecting the dignity and privacy of the patient, communicating therapeutically throughout the procedure, all while maintaining a sterile and safe technique when inserting the catheter” (Manz et al, 2013, p. e230).
The final layer of the food forest garden is the vertical climbers. These plants are opportunistic and take advantage of the vertical spaces afforded by the overstory layers. Examples of edible climbers include kiwi, cucumbers, climbing nasturtium, passion fruit, pumpkin, soybeans, wild grape, zucchini, squash, hops, grapes, climbing peas, and honeysuckle. Some of these plants (for instance pumpkins and squash) might be considered ground cover since they typically creep along the soil. However, with training, they can wrap themselves around canopy trees and grow vertically. These climber plants are versatile, and adapt well to new dimensions of opportunity and growth. Their edible parts add delicious and aesthetic contributions to the forest garden and their vertical growth makes the most of the garden space.
Climbers also “…provide important intercrown pathways for many canopy-dwelling animals and so are important ecosystem engineers. Without these vine connections, moving from tree to tree would entail descending to the ground where these animals are very susceptible to predation” (Putz, 2012, p. e1). “The abundant leaves, flowers, and fruits of [climbers] also represent important food resources for animals, and contribute substantially to biogeochemical cycles” (p. e1). As well, “With their high photosynthetic production and sizable biomass, [climbers] also make a significant contribution to carbon sequestration” (Butler, 2012, p. e1).
This adaptive, fruitful layer can be likened to the final technological layer used in the BSN-PB program. This layer entails iBook authoring by faculty to create customized reading and learning resources, specifically designed for the program. This layer is just being launched at the moment. A MAC computer is being used to create iPad friendly iBooks for the nursing students to use in their course work (see Figure 8).
Our program is not looking to replace existing electronic textbooks, but to enhance the quality of resources available to our students. We can also create ebooks that focus on topics not well covered in textbooks. For instance, the author is working on an ebook focused on behavioural states in newborns and the effects of music on these states. This is content that is not available in any textbook to date, yet is a valuable way to teach students about newborn consciousness, needs and comforting patterns. Like the climber level of the food forest, these ibooks will add necessary resources to increasing knowledge, adding substance and flavor to the curriculum, and augmenting existing resources with multimedia rich content. “With iBooks Author you have to be your own editor, proofreader, and marketer. On the other hand, iBooks are interactive, fun to look at, and students will be highly engaged.” (Moorefield-Lang, 2013, p. 19).
In this paper, the metaphor of a food forest garden was applied to describe the ecosystem of technological layers used in a BSN-PB program in Western Canada. This metaphor provides a rich analogy of holistic interchange, synergy and dynamic growth that is mirrored in the combined attributes of the technology selected for the program. This combination of technologies provides robust access and learning enrichment within this blended post baccalaureate nursing program.
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June Kaminski is currently the Program and Curriculum Coordinator for the BSN-PB Program at Kwantlen Polytechnic University in British Columbia. She is also the CJNI Editor in Chief, President of the Canadian Nurses for Health and the Environment; Past President and Director at Large for Sigma Theta Tau International, Xi Eta Chapter; and Editor in Chief of the Online Journal of Nursing Informatics In 2012, June was honored to receive the CASN and Canada Health Infoway’s inaugural Nursing Faculty E-Health Award 2012 in Ottawa Canada. She offers the Nursing Informatics Learning Centre for nurses.