NUR 671 Module 6 Instructional Unit Portfolio Part 3: Microlesson and Peer Coaching Example

Eight Minutes on the First Drops: A Microlesson Script and Peer Coaching Feedback for an Instructional Unit on Hand Expression

Student Name

Edson College of Nursing and Health Innovation, Arizona State University

NUR 671: Teaching in Nursing and Health-Related Settings

Instructor Name

Month Day, Year

Eight Minutes on the First Drops: A Microlesson Script and Peer Coaching Feedback for an Instructional Unit on Hand Expression

Part 3A: Microlesson Plan

Topic: Coaching a mother in hand expression of colostrum (segment of the full 90-minute unit).

Learners: Newly hired mother-baby nurses (for the recording, two classmates played learners).

Length: 8 minutes.

Objectives addressed: Objective 1 (explain when and why hand expression helps) and Objective 2 (demonstrate the technique).

Materials: Breast model, printed technique card, colostrum volume image, timer.

Teaching behaviors I set out to show: a problem-centered opening, explanation in short segments, demonstration with narration, checking understanding with teach-back and specific feedback.

Part 3A: Microlesson Script

Minute 0-1, opening problem. "It is 3 a.m. Your patient's baby is 18 hours old, sleepy and has fed twice in six hours. She says, 'I don't think I have any milk.' What would you say to her?" I paused and let both learners answer before going on.

Minute 1-3, short explanation. "In the first day, colostrum comes in small amounts, often only a few milliliters at a feed, which matches a newborn's small stomach. Hand expression lets her collect those drops to give by spoon. In one trial of mothers whose term babies were feeding poorly, those taught hand expression were more likely to still be breastfeeding two months later than those given a pump (Flaherman et al., 2012). And it needs no equipment, which matters at 3 a.m."

Minute 3-5, demonstration. Using the model, I narrated each step: wash hands; gentle breast massage; place thumb and fingers in a C shape a few centimeters back from the nipple; press back toward the chest, compress the fingers together, release; rotate around the breast; collect drops in a spoon. "Notice I am not sliding my fingers. Sliding hurts." I also showed the hands-off option: guiding the mother's own hand while I demonstrate on the model.

Minute 5-7, guided practice and teach-back. Each learner tried the technique on the model while I watched. I then asked, "Tell me how you would explain this to your patient in two sentences," and corrected one learner who described squeezing the nipple.

Minute 7-8, close. "When does hand expression help, and what is the one movement to avoid?" Both answered. I thanked them and named one thing each had done well.

Part 3A: Self-Review of the Recording

Watching the video, I saw that I talked over my second learner during her teach-back, which cut the check short. I also held the model at an angle the camera could not see. My opening question worked well; both learners leaned in. For the full session I will count to five after each question and practice the demonstration angle.

Part 3B: Peer Coaching Feedback

The peer coaching tool asks for feedback on the opening, clarity, engagement, checking for understanding and closure. The guidelines for effective praise in the module draw on research showing that praise helps when it names a particular behavior, sounds sincere and avoids routine, global approval (Brophy, 1981). Feedback also helps most when it tells the learner what to do next (Hattie & Timperley, 2007). I applied both to my classmate's microlesson on teaching a newly diagnosed adult to use an insulin pen.

Opening. You began by asking the "patient" what worried him most about injecting, which put his concern at the center from the first minute. Suggestion: tell him how long the lesson will take, so he knows what to expect.

Clarity. Your step-by-step sequence, from attaching the needle to holding for ten seconds, was easy to follow, and you repeated the priming step twice because people skip it more than any other step. Suggestion: show the dose window closer to the camera, as it was hard to read.

Engagement. You handed the pen to him before you finished explaining, which turned listening into doing. Suggestion: when he hesitated, you took the pen back quickly; giving him a few more seconds might build his confidence.

Checking for understanding. Your teach-back question, "Show me what you do after you click," revealed that he would have released too soon, and you corrected it calmly. This was the strongest moment of the lesson.

Closure. You summarized the steps but did not ask him what he would do if he was unsure. Suggestion: end with one question that checks his plan for getting help.

Overall, your lesson showed calm, patient-centered teaching with a clear sequence. The one change that would help most is leaving more silence for the learner to act.

References

Brophy, J. (1981). Teacher praise: A functional analysis. Review of Educational Research, 51(1), 5-32. https://doi.org/10.3102/00346543051001005

Flaherman, V. J., Gay, B., Scott, C., Avins, A., Lee, K. A., & Newman, T. B. (2012). Randomised trial comparing hand expression with breast pumping for mothers of term newborns feeding poorly. Archives of Disease in Childhood: Fetal and Neonatal Edition, 97(1), F18-F23. https://doi.org/10.1136/adc.2010.209213

Hattie, J., & Timperley, H. (2007). The power of feedback. Review of Educational Research, 77(1), 81-112. https://doi.org/10.3102/003465430298487