“Passing out,” “throwing up” and “having the sniffles” are phrases that nurses hear every day. While not clinical terms, everyone knows what they mean, right? Not necessarily, especially for nursing students who learned English as a second language.
Two nursing instructors at Georgia Perimeter College have created an app that explains idioms to such students, with the goal of helping them care for patients more effectively in the future.
“As Americans, we use idioms every day and think that everyone understands them, but those common expressions aren’t always taught to international students,” said Wakita R. Bradford, nursing community outreach and educational technology coordinator at Georgia Perimeter. “Our nursing students come from all over the globe and their English is often excellent. Still, they don’t always understand what we say.”
One example is when Bradford was discussing secondary IVs — also called piggyback IVs — in the school’s skills lab.
“An Hispanic student raised his hand and asked, 'What’s a piggyback?’ ” she said. “I realized then that idioms aren’t universal and that there was an area of our nursing education we needed to address.”
After reading student surveys from class and from a language support group for ESL students, Sue Buchholz spotted a problem.
“Phrases that we commonly used on tests or in class — things like 'bear with me,’ 'she’s tied up,’ 'don’t drink the Kool-Aid’ or 'get the chip off your shoulder’ — could be stumbling blocks to international students,” said Buchholz, an associate professor of nursing at Georgia Perimeter.
“Apps were growing by leaps and bounds, and we thought an app would be most useful because students could access it instantly from their mobile devices,” Buchholz said.
The two instructors proposed the idea at a Health Information Technology Scholars conference two years ago and earned a grant to take classes that would help them integrate technology into nursing education.
“Other nurses had proposed ideas that involved simulation or using the Web’s 'Second Life’ game, but an app was a unique idea,” Buchholz said. “Other nurses told us to let them know when we finished it, because they had the same problem in their departments. Wakita is a computer geek who built her own computer and wanted to learn how to create an app, so we figured all we had to do was do it.”
The GPC Nursing Idiomatic app launched on March 26, but neither woman expected it to take two years.
“I first took a GPC technology course on developing apps to see if it was even doable,” Bradford said. “I had done some programming years ago, and Xcode didn’t look that difficult to learn, but in order to create an Apple-based app, we needed a MacBook Pro computer.”
Every instructor at Georgia Perimeter receives a PC, but the head of the nursing department at the time offered grant money to help purchase a Mac for Bradford. She learned how to use the computer and then became fluent in Xcode.
“I used a tutorial, YouTube videos and a book leant to me by Steve Van Brackle in our technology department. He was an enormous help in answering my questions and helping me get past hurdles,” Bradford said. “It’s one thing to know what you want to do, and another to get there. In the long run, I guess I was more stubborn than the program.”
Buchholz gave up the idea of helping with programming after reading one chapter of “Apps for Dummies.” Instead, she scoured nursing exams and student surveys to find idioms to include in the app and helped Bradford write definitions for the expressions. The app includes an alphabetized directory of more than 200 idioms, a section that explains common homonyms (words that share the same spelling but have different meanings) and homophones (words that sound the same but are spelled differently).
“We also included a link to the Google Translate site, which is a great help to clinicians in the field when treating foreign patients,” Bradford said.
She is proud that the free app was accepted by Apple Inc. without revisions.
“We plan to add more expressions over time, and maybe some pictures. Our next step is to create a version for the Android platform, but for now, it’s very rewarding to have completed this project,” Buchholz said.
Other nursing schools have already asked to use the app.
“We know that this will help our ESL students do better in school and become better nurses,” Buchholz said.
If just one student sees it and uses it, the app will be worth all the effort, Bradford said. “I always think of that one student who was brave enough to raise his hand. How many others never did?
“We want our students to be active learners and to be engaged practitioners. If they’re pulling out devices and looking things up in class or lab, that’s fine with me. We didn’t create this app for fame and fortune. We did it for students.”