The idea of using YouTube in a didactic, nonclinical, baccalaureate pharmacology nursing course was based on the desire to engage students and enhance learning and retention of specific educational content (Wright & Abell, 2011). In selecting the specific subject matter, it was determined that the disease process studied needed to be extensive with a range of drugs available to treat a specific disorder. As several categories of drugs are available to treat different gastrointestinal (GI) conditions, GI content was selected for this innovation. GI didactic content had traditionally been presented in a two-day lecture that covered several subtopics of the disease process. The course coordinator knew that students struggled with trying to remember information regarding the different categories of drugs.
BACKGROUND AND OVERVIEW
The first step in changing the format of the lecture was to identify specific GI systems. Eight diseases and conditions affecting the stomach and colon were selected based on the textbook used and their frequent clinical presence: gastritis, peptic ulcer disease, geriatric- or surgery-related constipation, disease-induced constipation, acute or travelers' diarrhea, disease-induced diarrhea, nausea triggering the chemoreceptor trigger zone, and the emetic center. The categories were divided among groups of six to eight students. Because there were numerous drugs for each category, it was determined that each disease would focus on the three most common and familiar drug categories per GI disease or condition.
The groups were chosen using simple randomization based on their names. For example, three or four students whose last names were at the beginning of the alphabet were paired with another three or four students from a different part of the alphabet. Although creativity was highly encouraged and groups were directed to present their information in unique ways, a rubric was established with objectives to guide the groups and create uniform presentations, consisting of PowerPoint slides and the YouTube video. Establishing a rubric helped faculty maintain consistency, which was important as the GI topics included very different clusters of medications (see Table 1).
A major focus of the presentation was on the medications used to treat the disease process, including mechanisms of action, side effects, adverse effects, nursing management considerations, and potential interactions with other drugs. The students were asked to include a case scenario on how the drug would be utilized in the clinical setting and created YouTube videos to provide education about a drug or show a case scenario. Videos were graded on the information presented about the medication/drugs, flow of content, and originality. They could be a minimum of four to a maximum of six minutes in duration. It was not required that all members be included in the video, but highly recommended.
All group members participated and received a group grade. Originally, only the instructors graded the content of the presentations, but peer grading was introduced to encourage attentiveness among student observers. Peer grading involved the use of a scale (from 1 to 5) with room for comments to both praise and critique the presentations. A cooking timer was used during presentations to keep to the allotted time frame of 17 minutes; points were deducted for going over the time. The rationale was to prepare students for professional presentations; students were told when they had 5 minutes left.
STUDENT ROLES AND REACTIONS
YouTube is one of the most frequently used social media tools. It has eclectic usage, from comedic to serious, and can highlight personal information as well as music, movies, and other activities. One can search for any odd thing and find someone who filmed it and posted it to YouTube. The instructor selected YouTube because of its potential to educate others and its widespread use (Soukup, 2014). Groups used the group process to divide the work, format their video, and assign roles for the presentation. It was mandatory that each student take part and dress appropriately. As a bonus for their work, groups could submit one question to be evaluated as a possible final exam question using four criteria: 1) It had to be original, with no appearance of a copied NCLEX-RN(R) review book question. 2) It had to talk about one of the drugs and include the drug category. 3) It had to have the correct answer keyed. 4) The rationale for the correct answer had to be given. Although students could submit a multiple-response question, they were told that only one multiple-response question would be used on the exam per disease, meaning that only one student question would be chosen. Students had less than a week to submit their questions.
Writing an exam question was another way to show that students understood the information. They found that writing a four-answer multiple-choice exam question was not as easy as it appeared. The instructor evaluated the questions according to the established criteria and inserted selected questions on the exam with an identifying label (e.g., Grp1 [Group 1] - A client with gastritis[horizontal ellipsis]). Members of the groups whose questions were chosen received one extra credit point on the final exam.
STUDENT RESPONSES AND IMPLICATIONS
Initially, the students were not happy to learn that they were going to be doing a project in a three-unit pharmacology class. As groups began to work together on creative ways to film their videos and assign tasks for presentation, groups began to bond. Many presentations were informative and entertaining. Students' imaginative ideas manifested themselves well beyond faculty expectations. An unexpected benefit was that typically shy students were now "seen" by their colleagues.
Videos included animation, "flip book" drawings, and sock puppets; some mimicked television infomercials and spoofed TV shows or music videos. Some even included "blooper" reels. PowerPoints were skillfully done with the effective use of animation and backgrounds. Current students look forward to the project and readily share ideas with their groups. Because only eight or nine GI questions are used on an 85-point final exam, it is difficult to measure whether adding this assignment to the teaching of GI content has an effect on final exam scores. Typically only three to six of the group questions are selected for the exam. Faculty cannot control the sharing of questions outside of class, which can skew the results. It is important to note also that student grade point average changes slightly from quarter to quarter.
The essence of this teaching opportunity was to increase student engagement and ownership in learning. The incorporation of YouTube provides an engaging teach-back method of learning by empowering students to take learning into their own hands. It encourages creativity in presenting information and transforms the traditional didactic platform. Student learning will continue to adapt as technology changes. Faculty need to be open-minded as to different learning styles and ways to incorporate social media into student learning.
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