Introduction to Labor and Delivery: 8 hour Theory Day

Lesson Plan Template

Rachel Neale
Objectives Class Objectives
By the end of class the nurse will be able to:
1. Recognize normal vital signs for the
mother-baby pair.
2. Perform (with supervision) assessments
on mother-baby pair.
3. Locate necessary supplies in the L&D
room and operate the labor bed.
4. Identify at least 3 common interventions
for indeterminate fetal oxygenation
status.
5. Describe the use of oxytocin for
intrapartum and postpartum patients.
6. Assess their own learning during
orientation.

Teaching theory Social Learning Theory

There are 4 phases of this model: attention, retention,
reproduction, and motivation (Keating & DeBoor, 2018)..
“Common teaching strategies such as simulation, clinical
experiences, and role-play are often used with social learning
theory as a framework” (Keating & DeBoor, 2018, pg 110)

Materials/ Materials required for this class include:

Resources -simulation lab for practicing assessments on mother-baby: low-
fidelity mannequins, Ultrasound and toco for external fetal
monitoring (EFM) simulation, stethoscopes
-empty labor room
-conference room with PowerPoint access
-provide learners a handout of outline of information with space
to take notes. Promotes student engagement.
-scavenger hunt activity
-IV equipment will be available for hands-on practice to prime
lines
Content See outline below

Method/Activities/ The material will be presented in a variety of formats, though

Experiences the foundation will be presented via PowerPoint. The theory day
is separated by several innovative teaching strategies listed
below:
 1) Simulation: nurses will practice assessments for mother-
baby couplet on low-fidelity mannequins in the
simulation lab. (Miles, 2018)
2) Simulation: nurses will play with labor bed by taking it
apart and putting back together. Nurses will also practice
priming intravenous (IV) tubing and starting boluses in
an emergency. (Miles, 2018)
3) Gamification: nurses will go into a labor room and
perform a scavenger hunt with a buddy to find various
supplies in the room. (Bradshaw et al., 2021)
4) Case-based learning: nurses will look at case studies for
analyzing gravida/para status as well as case studies for
providing interventions for Category II tracing and
postpartum hemorrhage (time permitting). (Yale, n.d.)
5) Self-evaluation: the assignment at the end of class helps
the student engage in their metacognition.

Assignments Students will end the day by answering two questions: What are
3 things that I learned today? What are 3 things I want to
know/learn from my preceptor tomorrow? (Will share with the
group)

Assessment Nurses will complete a pre-test and post-test to determine

learned content. Preceptors will bridge identified gaps from the
pre-post-test results.

Content

I. Introduction 0800-0900

a. Instructor: experience in nursing/ L&D, current role

b. Orientees introduce themselves and previous experience (if multiple people)

c. Expected outcomes from the theory session

i. Rules: be respectful, go for bathroom breaks/eat when needed, will take a

30 minute break for lunch at noon

d. Objectives (see listed above)

e. Orientation-covered by Jen Musi prior but quick review

 i. Not expecting you to be an expert (Association of Women’s Health,

Obstetric and Neonatal Nurses, 2021)

ii. Want you to independently handle “‘normal patients”

iii. Be able to call right people when something is not normal

iv. Average 14-16wks, sometimes longer which is ok!

f. Coping with orientation: please let Allison or your instructor know if you aren’t

coping well, we want to support you- Labor and Delivery is an intensive care unit.

Chaplains are available for life-threatening clinical situations. We want to know if

you are struggling.

II. Thinking about our thinking: Metacognition

A. We are most successful in learning when we know how we are learning, or how we

learn best. Keep that in mind as you go through orientation, what works for you and what

doesn’t, apply accordingly (Ambrose et al., 2010).

B. Critical thinking-question why you came to a certain answer, or why your preceptor

came to a different conclusion.

C. Self-evaluation- always think about what you are doing well and what can you

improve.

D. Quick pre-test (10 minutes)

III. The basics 0900-1000

A. Maternal VS and assessment

1. VS: HR 60-100, RR 16-20, O2 95-100%, temp 97.7-100.3, BP <140/90, or

<160/105 *severe range*

 2. Typical assessment: pre-eclampsia s/sx, fetal movement, vaginal fluid (if any),

ctx pain/pain in general, breath sounds, Leopold’s maneuvers

B. Newborn VS and assessment

1. VS: HR 110-160, RR 30-60, O2 (varies), temp 97.7-100.3

2. Assessment: head-to-toe

C. Intrapartum fetal assessment (EFM)

1. EFM monitoring

2. What is normal-basic understanding

a. 110-160 baseline

b. Accelerations good, decelerations bad

D. Go to simulation lab and practice assessments on each other, pretend with

mannequins, practice placing EFM monitors on a patient

IV. Pregnancy/Labor process 1015-1100

A. Typical pregnancy and related terms

1. Term gestation: 38 and 0 to 41 and 6

prior to this is late pre-term and after is post-dates

2. Pre-term technically is less than 37 weeks, baby goes to NICU if less than 35

and 0

3. Define: Prime vs. multip (colloquial phrases)

4. Define: SVE, ctx, SVD, MSAF, AROM/SROM

5. Gs and Ps (practice with a couple examples)

6. Labor: 0-10cm (the four stages of labor)

a. Dilation
 b. Effacement

c. Station

V. Play in a labor room 1100-1200

1. Scavenger hunt for various supplies

2. Play with a labor bed, press different buttons, break down and set-back up

3. Discuss emergency buttons and what they mean

4. Discuss room orientation/call bells/safety education with patient and support

person

VI. Lunch break 1200-1230

VII. Delivery Meds 1230-1330

1. Oxytocin

a. Intrapartum use

b. Postpartum use

2. Delivery kit (brief introduction)

a. Pit

b. Cytotec (Different than induction cytotec!)

c. Terbutaline

VIII. Common interventions

1. Indeterminate fetal oxygenation status

a. Typical interventions: reposition (L lateral), fluid bolus, pit off, O2

2. Case studies to reinforce interventions

IX. Labor coping 1345-1445

1. Nonpharmacological
 2. Nubain/Benadryl

3. Epidural- fentanyl/ropivicaine

4. IV equipment practice: prime tubing, spiking bags, manually entering a bolus

in emergencies

5. Group activity: create a menu of labor coping options for a patient; provide an

opportunity to discuss coping vs. suffering

X. Common complication hemorrhage (basics, time permitting) 1500-1600

1. Hemorrhage: 4 Ts

a. Risk factors

b. Common meds

2. Case studies

XI. 1600-1630 evaluations

-perform post-test

-“What are 3 things I learned today?”

“What are 3 questions I have for my preceptor tomorrow?”

Self-assessment Reflection

1. Were the instructional objectives met? How do I know students learned what was

intended?

As this class has not been officially taught yet, I would imagine the instructional objectives

would be met, as the information learners received in the class are reinforced by the preceptors

on the floor. I can assess student learning through the pre-test and post-test and seeing what it

was they gained in knowledge from the 8 hours. The preceptors could also potentially take the

post-test of their orientee and use it for further learning engagement to ensure the objectives are

met.

2. Were the students productively engaged? How do I know?

The students, in theory, would be engaged, as the didactic portions are well broken up with

active teaching strategies such as simulation or case studies. In addition, a handout will be

provided leaving certain words blank so that learners can stay attentive during the slideshow.

Learners will demonstrate their engagement or lack thereof based on their level of questioning

and body language. The educator can use the nonverbal language as a sign to get up and move

around, or adjust the schedule of curriculum if necessary to keep the learners engaged.

3. Did I alter my instructional plan as I taught the lesson? Why?

The lesson plan is written with the knowledge that some groups of learners will move more

quickly through the material than others, and therefore certain aspects of the curriculum may be

covered or pushed on to another theory day (or taught on the floor by the preceptor). For

example, a group of new grads may need more time with the IV pumps, whereas a group of
internal transfers from other units may want to skip that step and spend more time discussing

hemorrhages and pharmacological interventions. The lesson plan is meant to be very full in its

schedule; I would rather have too much material to cover than not enough material.

4. What additional assistance, support, and/or resources would have further enhanced this

lesson?

I think bringing in other disciplines for education would have been a great benefit to the theory

day. For example, getting a doctor, midwife, or pediatrician to stop by could start off positive

relationships between the new employees. I also left out videos in my planned curriculum, but

videos would be helpful to the visual learners in the class, and could keep breaking up the

didactic lecture portions.

5. What was my overall impression of the teaching experience?

I think this teaching experience would be exciting, though nerve wracking to make sure all the

right material is being addressed. I know right now as I prepare to present this lesson plan to my

manager and education committee I am anxious about whether or not I am putting forth both the

most pertinent material but also the most up-to-date information. That being said, I think the

variety of innovative teaching strategies are a great start to the orientation process, and gives the

learners multiple tools to be successful. My impression of teaching via the short video was that,

though time consuming, I was able to present the information in an interesting, and professional

way, and believe it presents the information well. If the education committee decides against my

theory day proposal, then it will be because they have been adequately informed through my

presentation and are choosing a different path based on their experiences, not due to my lack of

effort.
 References

Ambrose, S. A., Bridges, M., Di Pietro, M., Lovett, M. C., Norman, M. K. (2010). How learning

works. 7 Research-based principles for smart thinking. San Francisco, CA. Jossey-Bass.

Association of Women’s Health, Obstetric, and Neonatal Nurses (2021). Orientation of the

registered nurse to the perinatal setting. JOGNN. Doi: 10.1016/j.jogn.2021.11.003

Bradshaw, M.J., Hultquist, B.L., Hagler, D.A. (2021). Innovative Teaching Strategies in Nursing

and Related Health Professions (8th Ed.). Jones & Bartlett Learning.

Keating, S.B., DeBoor, S.S. (2018). Curriculum Development and Evaluation in Nursing

Education (4th ed.). Springer Publishing Company.

Miles, D.A. (2018). Simulation learning and transfer in undergraduate nursing education: A

grounded theory study. Journal of Nursing Education 57(6). Doi: 10.3928/01484834-

20180522-05

Yale (n.d.). Case-based learning. Poorly Center for Teaching and Learning.

https://poorvucenter.yale.edu/strategic-resources-digital-publications/strategies-

teaching/case-based-learning