Dr. Latisha Hanson, DNP, PMHNP-BC
Assistant Professor of Nursing at Columbia University School of Nursing; Director of Diversity Programming at Columbia University School of Nursing
Dr. Hanson teaches the Psychiatric Mental Health Nursing course for Masters students in an accelerated RN program, Masters Direct Entry (MDE), as well as courses in the DNP Psychiatric Mental Health Nurse Practitioner Program for advanced practice nurse students. The MDE Psychiatric Nursing course typically enrolls about 40 students, who meet for five-hours, twice a week, for five weeks. Typically a fully in-person course, the shift to remote teaching and learning in Spring 2020 required Dr. Hanson to reconceptualize this heavy and challenging course material for a fully online setting. Dr. Hanson met the moment by flipping her class to emphasize engagement, prioritizing connection, resilience, and equity, and introducing areas of support and connection for students outside the classroom. Read on to learn more about what Dr. Hanson did in her course, what lessons and experiences she’s carrying forward, and the advice she has for other instructors at Columbia.
Flip the Classroom for Engagement
The course has evolved over the years, in terms of my own teaching. However, nothing changed it as much as the pandemic; it was the first time I’d ever done remote teaching. My big question, even before the pandemic really, had been how to use the class in terms of student engagement. Then we had a switch to remote, and it forced us to reimagine teaching and learning and how our students learn. We had the ability to communicate and connect that we didn’t previously have.
In the beginning, one of the challenges with Zoom was getting everyone on the screen and determining their engagement. In the classroom, I could walk around and see their faces. So, early on, I started incorporating breakout rooms throughout the day–in the face-to-face class, I had six tables, so I was just going based on the classroom and made six breakout rooms. I would then pop into the breakout rooms, which gave me a chance to sit with the students, hear how they were learning, see how they were engaging with the material. This was one of the early changes I had thought about making. There were also times where the chat had a life of its own; for students this was a new way of communicating. The students who would never talk out loud in class loved that they could communicate and contribute without having to speak; they could write them and feel more comfortable with this medium. The chat also helped me keep in contact with students I hadn’t heard from, to connect and see how they’re doing. Instead of sending an email outside class time, I could send them a private message in the chat.
Once we all felt more comfortable with Zoom, and I felt I understood how this class worked remotely, I felt I had the ability to flip the class. I could make it so the material that was heavy in terms of the learning–the lectures–these could be videos that students watch before class. Then, in class, we do cases. We could spend more time focusing on ways to engage the material. We could bring in patient questions from clinical, talk about scenarios, and implement case studies; students could apply the material they learned. This flipped model really brought the learning to a whole other level. The other nice thing about flipping the classroom in this way is when students were out sick. I didn’t imagine how often students would be out sick during this time, and it really hit hard because our students were working in the hospitals as well. My class is only five weeks long, so if you miss a week, you’re behind nearly a month of a semester class. Before this flipped model, in person, students would miss out. They’d have to get notes from a colleague or classmate. They often felt like they couldn’t keep up with the material. But having the class flipped, it enabled them to do the work when they felt well.
I’ve maintained this flipped model, even when I went back to in-person teaching. I’ve left some portions so they can engage with the lectures ahead of class. It works for when students are out sick. But also, having the videos and the closed captions on those videos enables everyone to have the words written out, and students really enjoy that. With the recordings, they can slow me down and rewind. It gives them an opportunity they don’t have in a live lecture, and they feel more prepared.
Prioritize Connection, Resilience, and Equity
Connection and Resilience
I knew I needed to have time in class for students to connect. In the Fall of 2020, some students in the program hadn’t met each other. I was wondering how do I get them talking to each other and connecting beyond an assignment? I started using attendance as an opportunity, where I’d have students say one highlight of their day, something they’re interested in or excited for. Then they’d “popcorn” it to each other and we’d go around the class. I took attendance, but it was a way for students to learn about each other and hear how other people were coping. I found moments that weren’t about the didactic course material, but rather building in resilience and coping that students really needed during this time. It helped give confidence to students who maybe wouldn’t usually speak otherwise. I’d also invite students to bring a pet or something that gives them comfort for the first five or so minutes of class–they’d bring their dogs, cats, one student brought a plant. And it was time for lighthearted connection, and people had a chance to see and learn about each other.
In the classroom, I liked learning walks and getting students moving. Being remote, we weren’t moving; we did a lot of sitting. I’d encourage students to try and move every time we took a break, just an opportunity to cope and get some of the tension out of their bodies. During these breaks, I’d play 15-minute meditations. These acted as countdowns, but also for students who didn’t want to move, they could have scenery change and participate in the meditation and deep breathing. I’ve kept these meditation wellness breaks and opportunities for connection throughout the in-person classes. You don’t really know what students are going through. There’s no real time for them to tell you, “it’s been hard for me.” Adding in these wellness measures really helped. I didn’t realize before how much students value that support and really need it. I tried not to take too much from their lecture or their learning, but I found it was really helpful for them to connect, to talk about how they felt. If there was something going on, it gave them a way of engaging with the learning.
Equity
During the pandemic I realized more than ever our need, as instructors, to do more to aid in our students’ growth to be equitable healthcare providers and to be anti-racist instructors. I think George Floyd and other elements happening during the pandemic, where people realized “Hey, we’re not putting enough in our pedagogy around anti-racism,” really defined an anti-racist pedagogy movement at this time. I personally knew there needed to be curriculum changes; around this time, I added in positionality: who I am is going to define how and what I teach. Addressing the power dynamic of the professors to students to consider how we increase equity for our student learners in the classroom.
In thinking about equity, I went to the CTL and OVPFA session led by Dr. Asao Inoue on labor-based grading. I found this mind-blowing, that how much of the language and what we teach is defining how and what students learn and their grades. So, I started implementing labor-based grading in the curriculum of one of my DNP classes as well. I wanted to see how students would be able to do if their grades aren’t defined just on their ability to memorize material. I expanded the time limit on my quizzes and gave students multiple opportunities to complete the quizzes. I let students know that I still want them to learn the material, but that it’s not just about memorization. It’s about interacting and learning. Utilizing assessment and grading strategies like labor-based grading helped me to move away from competitive learning in order to embrace the benefits of collaborative learning.
Provide Support and Connection Outside the Classroom
Connection was important to incorporate in other activities. We put together a “Coffee and Tea with MDE” event, which created an opportunity for faculty, staff, and students to connect outside the classroom. Someone would share a recipe and ingredients each week, and we could come together and cook together over Zoom. This gave faculty, staff, and students a space to come together in a forum where the intent wasn’t learning, but rather an opportunity to connect with others at the school. Students felt like they could talk to their professors or other people in a way that they hadn’t previously connected; it was almost like mentorship. It was about discussing how people felt about the pandemic, how complicated life was. These open-type forums allowed people to share their thoughts and talk about their fears.
Another offering we started during the pandemic, and one that has been kept up, was for RN students doing clinical. Dr. Jennifer Dohrn recommended we offer circles of care. This was another way of connecting everyone via Zoom. Early in the pandemic, hospitals were losing so many people, and students were so overwhelmed. These circles of care allowed us to talk about how we were coping and what was happening; they were so important. It was a chance to say to students: “you are feeling this, and it’s happening to you, but you may not be recognizing that you are stressed or overwhelmed.” They were able to hear from each other, have a place to talk, and see how others were coping. It gave us faculty a chance to connect and check in with the students to make sure they were okay.
In addition to helping students find connection outside the classroom, I also learned that the curriculum and material I teach is just the tip of the iceberg for anti-racist pedagogy. Outside the classroom I joined multiple antiracist committees to improve as a faculty member and provider and to work with the school to grow our ant-racist values. Committees like recruitment, retention and advancement of a diverse work force and anti-racism student retention working groups have the ability to aid in the diversity of students, staff, and faculty. Along the way I have met students, staff, and other faculty that have aided in my growth, and I continue to challenge myself and those I interact with to continue to expand and develop our anti-racist values. Some take aways that I have from my anti-racist work is the need for compassion, empathy, and listening to our students. The discussions often cause discomfort, but they are still needed.
Advice for Instructors and the Future of Teaching at Columbia
Compassion and connection go a long way.
Sometimes as professors we come in thinking we have to get this material done, and we have to do this amount of learning in order to prepare the students. But taking time to connect with the students, I really found to be valuable. I know some people might pushback or state it’s not directly related to the learning. It will go a long way in terms of the students feeling comfortable and asking for help, or just feeling like they are prepared. Partner with them in their learning, so that you can get an idea of what they’re going through and find out what they’re interested in learning. Compassion really goes a long way. Students are going through the same thing that everyone is; they’re stressed too, they’re going through a lot. I think with that level of anxiety and stress, it really impacts learning. So we have to come to this in a way to understand that some students might not be doing the best but it could be because of things that are going on that they haven’t told you about. If you take that time to connect, they’ll be more likely to tell you.
Flip for flexibility.
Flipping the classroom really gave me the flexibility I needed for the class, especially when accommodating students who were sick. It gave them an opportunity to still learn at their own pace. Flipping the class made it so there were different ways of learning and engaging with different mediums, whether videos or other visual elements. The closed captions made such a big difference for students, just being able to see the words and watch the recordings at their pace. It also helped to have clear expectations of what material was asynchronous and before class, and what was expected synchronously, in-class. Students knew what they could expect when coming into the class.
Use all available resources.
I know I’ve always had the CTL, but it really wasn’t until the pandemic that I found myself emailing and asking for help. Having access to the workshops and open office hours was so valuable. I could drop by with something that wasn’t working and get support. I also connected with my colleagues for support. There’s such phenomenal faculty at Columbia and we often don’t get a chance to hear what they’re doing and see how they’ve done their classes. So I found it really valuable to reach out to other instructors and ask them questions; having that connection with others was really helpful.
Work toward an anti-racist and equitable teaching and learning future.
My curriculum and the material I teach is just the tip of the iceberg for anti-racist pedagogy. The additional elements (for my context) include the classroom, the School of Nursing, the Medical Campus, the main campus, and the communities we serve. Therefore, we cannot just add diversity into our curriculum to meet our goal to be anti-racist instructors. We have to incorporate history, social determinants of health, and discussion to foster our students to have the type of thinking necessary to be antiracist providers. It’s not one size fits all for each course or instructor. It will take collaboration from patients, the community, students, faculty, staff, and leadership. It is a process that is ongoing and evolving.