Teaching on Drug Administration - Essay Example

?Reflection on Teaching on Drug Administration Introduction Nurses have a major role to play in the system of health care. Advances in recent times in the field of health care have imposed burden on the nursing faculty to reinforce their knowledge and thus their education strategies. One of the important tools for effective nursing education, both for tutors and for students is reflection. That is why reflection has been considered as a very efficient tool for development for nursing practitioners. Reflection, as such is a process through which a person evaluates and examines his/her own thoughts and actions (Alexander, Fawcett and Runciman, 2006, pg.2). As far as nursing practice is concerned, reflection is a process by which one focuses on the interaction between oneself and the environment, including colleagues, in a particular situation, with intentions to examine and evaluate the interactions. “Reflection gives scope for better understanding of oneself so that existing strengths can be used to build-up for future actions" (Somerville and Keeling, 2004). While reflection is the key to successful learning process, current literature plays a major role in these developments. Through updated journals and texts, present studies by critics and writers, we are able to meet the goals for the improvement of analytical thinking skills such as being able to identify problems that might arise, being aware to new or different ideas, and anticipating the consequences of one’s actions. According to Brandon and All (2010), many nurse educators continue teaching the way they have been doing, despite the need for reforms. However, pedogogical research has indicated the need for change in nursing curricula. The emphasis is to shift from traditional courses to concept-based courses which com across across clinical settings. In order to accomplish such a useful change, it is very important for the nurse teacher to understand the role of "the rapidly advancing profession" (Hamner and Wilder, 2001; cited in (Brandon and All, 2010). In using reflection as a tool for the development of the professional nursing practice, a plan can be designed to meet the goals of the reflective activity by recording thoughts, observations, feelings, activities and questions (Burns and Grove, 1997). Through this, the effective practitioner can be challenged to think in new ways, raise new questions and explore new ways of problem-solving. Thus reflection is key for successful learning outcomes and literature plays a major role in such developments. In this essay, reflection on the methods, strategies and outcomes of teaching students about drug administration will be done with reference to current literature. Reflection and critical analysis Gibbs Model of Reflection will be used for evaluation and examination of the teaching methods and outcomes because the framework is straight forward and includes a cycle of clear description of the clinical situation, analysis of the feelings of the practitioner, evaluation of the actions during the situation, analysis of the various activities and experiences during the situation and a conclusion for lessons in future (Online learning, 2006). Description of the teaching process Student nurses were taught about administration of drugs in nursing practice. The aims of the teaching session was to enhance the knowledge of the student about the safe drug administration. The objectives and learning outcomes of the teaching session were: 1. To know the common causes of medication errors 2. To know the right method of administration of medication 3. To know the different routes of administration of medication and nursing considerations pertaining to those routes. 4. To know the importance of understanding the reason prior to dispensing the medication. 5. To know strategies to assure proper, clear, concise and easily understood methods of documentation of drug administration. 6. To be aware of patient safety goals. Procedural instruction in the teaching session was imparted through traditional method of education, after which teaching was done using the principles of Constructivist Learning Theory. Thus, to facilitate constructivism, the students were encouraged to be autonomous. Primary data was assimilated from various interactive, manipulative, physical and raw data. Students were allowed and encouraged to be creative, predictive, classify and analyse their assignments. They were encouraged to inquire, communicate and critically think. Behaviour towards students, strategies for instructions, teaching activities and teaching content were mainly based on the response from students. Communication between teachers and students and between students was encouraged. Follow-up questions were put and elaboration of the answers were sought to gain information about the depth of understanding by the students. Teaching was done in 4 sessions and involved both theoretical and practical aspects. A timetable was put on the notice board and students were advised to prepared for the sessions based on the time table. In the first session, general information regarding drug administration by nurse was provided in a traditional manner. Emphasis was laid on various modes of drug administration, the importance of right dose, the importance of understanding the reason behind drug administration, common medication errors and proper strategies of documentation. The next two sessions were about practical experience and students were taught how to administer drugs and record it properly. In the last session, a questionnaire was administered to all the students with intentions to evaluate the understanding of the techniques, basic aspects and purpose of administration. 2. Critical analysis In the first session, students were asked to share information which they gained from different readings. Since most of the students sought information from the standard text book and did not attempt to gain information from other sources, not much exchange of information occurred. Hence, we had to provide a list of sources from where information had to be sought, including library and internet sources. Students were asked to read-up information from these sources too. According to Bruner (1996), "learning is an active process in which learners construct new ideas or concepts based upon their current/past knowledge. The learner selects and transforms information, constructs hypotheses, and makes decisions, relying on a cognitive structure to do so." In this teaching session, the principles of constructivism were followed diligently. Students were encouraged to actively participate in the learning process. The topic of drug administration by nurses was divided into subsets like: common medication errors, routes of drug administration, dosage calculation and recording of drug administration. The topics were divided between the students and they were asked to present and discuss the topics individually. The students were encouraged to shoot questions across each other and fuel open discussions. After the students discussed between each other, the teachers started discussing points which were not covered by the students. "The major theme is that learning should be an active process in which learners construct new ideas or concepts based upon their current or past knowledge. With roots in philosophy, psychology, sociology, and education (Hoover, 1996), constructivism is founded on subsets of research" (Brandon and All, 2010). Students were encouraged to opine about their previous learning and observation experience with regard to drug administration which is a very aspect of constructivism. Constructivism may be defined as "active construction of new knowledge based on a learner’s prior experience" (Koohang et al, 2009). Thus, learning through previous experiences is a very important component of constructivism. In this teaching session, students were encouraged to learn actively and not passively. Even various modes of drug administration and common errors in medication were learnt in an active manner. According to Woolfolk (1993), "the key idea is that students actively construct their own knowledge: the mind of the student mediates input from the outside world to determine what the student will learn. Learning is active mental work, not passive reception of teaching." Hence plain presentations, without discussions were not employed in the teaching sessions. Nor did teachers do all the presentation work. According to Honebein (1996; cited in Koohang et al, 1996), the goals of teaching in constructivism is to provide the students experience with the construction process knowledge, to provide the students with experience in various multiple perspectives and to provide appreciation for the same, to encourage students voice in learning process and to encourage ownership, to embed "learning in social experience" and to "embed learning in realistic and relevant context", to encourage students to use various modes of representation and finally to "encourage self-awareness in the knowledge construction process." In the next two sessions opportunities were given to the students to get hands-on-experience. Each student got about 4-5 chances to administer drugs and record drug administration. Each student also watched other students perform the task and learn from their experiences and mistakes. The students were encouraged to give their opinions and ask doubts about the techniques, dosage, recording, etc. According to Murphy (1997), in any teaching sessions, teachers take up roles of monitors, guides, coaches, facilitators and tutors. Open discussions were encouraged during practical sessions. After one student performed the task, other students were encouraged to opine if the procedure was right or wrong, and how it could have been improved. Cross questioning between students was encouraged. Students play an important role in not only mediating learning, but also the process of controlling learning. Various objectives and goals of teaching are actually derived through them (Murphy, 1997). The students were taken to emergency room settings where drugs need to be adminstered rapidly and at th same time recording of drug administration must be done. They were also taken into new born units to demonstrate gentle handling of patients and careful administration of minute quantities of drug. The students were put in situations that challenged various conceptions which were there even previously, so that contradictions develop providing scope and fuel for discussion. In constructivist teaching, teachers must provide the students with various learning situations, skills, environments and the tasks and content must be realistic and authentic, and must relate to and simulate "real world" as much as possible. Thus, construction of knowledge must be aimed at and not just reproduction. Such a construction of knowledge takes place only in individual contexts after collaboration, experience and social negotiation. "The learner's previous knowledge constructions, beliefs and attitudes are considered in the knowledge construction process" (Murphy, 1997). Primary sources of data were used for information gathering and during discussions and arguments, students were asked to quote from primary sources only. It is very important to use primary sources of data for information gathering to ensure real-world complexity and authenticity. Active learning is a must for nurses who are backbone of any health care system. They play a major role in the assessment and treatment of patients. They promote the emotional well being of a patient because of their sense of empathy and caring feeling. They work with people suffering from various types of illnesses in diversity of roles and actions demanding expert skills and professional knowledge. The situations are many a times complex requiring an understanding of the complexity of the situation. Every nurse-patient encounter is unique and there are no fixed solutions to many nursing problems. Developing your professional knowledge, skills and competence is a way of meeting the demands of modern professional practice. As Brandon and All (2010) rightly put it, "nurses are far more than beings of memorization. They must be lifelong, adult learners who engage in reflective practice, self-critique, and self-direction, and they must be able to synthesize information, link concepts, and think critically. Thus constructive leaning process helps in acquisition of appropriate knowledge and experience. According to Merrill (2008), "constructivist strategies help bridge the gap between neurological and cognitive sciences and classroom teaching and learning." 3. Evaluation In the last session, the understanding of drug administration and the outcomes of the teaching were evaluated by administering a questionnaire to the students. Most of the students were able to answer about basic questions pertaining to drug administration. However, many of them were not yet confident in drug dosage calculation. Nursing theories or models are important teaching aspects of nursing practice. They provide information about definitions of nursing and nursing practice, the aims, objectives, goals and functions of nursing practice and also the details about principles that form the basis of this practice (Wesley, 1995). Dreyfus model is an excellent and appropriate model to discuss on learning administration of drugs. According to this model of nursing theory, acquisition of skills through external instruction by individuals passes 5 important stages which are Novoice, Competence, Proficiency, Expertise and Mastery (Benner, 1984). This model was first proposed by famous theorists Stuart Dreyfus and Hubert Dreyfus in 1980 (Benner, 1984). The theory gained much attention due to the works of Benner who used this theory to define stages of clinical competence. The first stage of skill acquisition is the 'Novoice Stage'. In this stage, the individual mainly concentrates on following rules that are free of context. He does not feel responsible for anything else other than following the rules properly. In this stage, competence is demonstrated by active decision making. Those who formulate their own rules and use intuitions in decision making exhibit proficiency (Benner, 2004). The next stage is that of 'Advanced beginner'. In this stage, the individual's perception of situation is still limited. He treats all aspects of work equally and separately. In the next stage, the learner becomes 'Competent'. He is able to perform many activities at a time. He is also able to perceive various information well. On the whole he is able to cope with crowdedness. The individual plans deliberately for longer term goals (Benner et al, 1996). At the end of the teaching session, the students are in the “advanced beginner stage”. Through their postings in the clinical settings, they will continue to actively learn and acquire skills of appropriate drug administration. 4. Feelings As teachers, we enjoyed the teaching process and the method chosen for teaching. Students were actively involved with the help of seminars, presentations, cross-questioning and open discussions. Even the student enjoyed the learning process and many felt that most of their doubts about drug administration were cleared. However, we felt that in this advanced age of teaching through technology, we could have used more internet sources. Mannikins could have been used prior to real first-hand experience, so that the students acquired skills much before trying on children. However, we have kindled scope for active learning and the students will continue to do so throughout their postings. This teaching session has been a memorable experience of sharing knowledge, reading exhaustive literature on the topic and preparing questionnaires. 5. Scope for future learning Constructive learning has proven to be an excellent teaching and learning strategy where there is active participation from both teachers and students. This type of teaching method can be employed even for other nursing learning topics. For procedural teaching, use of mannikins prior to performing the procedure on patients increases the skill of the student. Acquisition of skills can occur only in stages through active learning, perseverance and regular exposure. Conclusion Constructive learning is one of the useful tools for teaching applicable for nursing teaching. As such, nurses are very important in any health care setting and to maintain high standards of competence, nursing need to constantly upgrade their knowledge by active and continuous leaning. Constructive learning allows assimilation of data from primary sources, critical analysis of literature, open discussions, real-life experiences, challenging situation experiences, cross-questioning, interactions between students and between students and teachers and critical thinking. Thus, it can be opined that tasks like drug administration can be taught through this popular method of learning. References Alexander, M.F., Fawcett, J. & Runciman, P.J. (2006) Nursing Practice Hospital and Home: The Adult. Third Edition, Churchill Livingstone: Edinburgh. Benner, P., Tanner, C., and Chelsa, C. (1996). Expertise in Nursing Practice: Caring, clinical judgment. New York: Springer Publishing Company Benner, P. (1984). From novice to expert: excellence and power in clinical nursing practice. California: Addison-Wesley Publishing Company. Benner, P. (2004). "Using the Dreyfus Model of Skill Acquisition to Describe and Interpret Skill Acquisition and Clinical Judgment in Nursing Practice and Education". Bulletin of Science, Technology & Society, 24 (3), 188-19. Brandon, A.F. and All, A.C. (2010). Article: Constructivism theory analysis and application to curricula. Nursing Education Perspectives. Retrieved on 9th February, 2011 from http://www.highbeam.com/doc/1G1-225247238.html Bruner, J. (1996). The Culture of Education, Cambridge, MA: Harvard University Press. Burns, N., Grove, S. K. (1997). The Practice of Nursing Research: Conduct, Critique and Utilisation. 3rd edition. Philadelphia: W. B. Saunders Co. Koohang, A., Riley, L., and Smith, T. (2009). E-Learning and Constructivism: From Theory to Application. Interdisciplinary Journal of E-Learning and Learning Objects, 5, Retrieved on 9th February, 2011 from http://ijklo.org/Volume5/IJELLOv5p091-109Koohang655.pdf Merrill, A.S. (2008). The impact of constructivist teaching strategies on the acquisition of higher order cognition and learning. Retrieved on 9th February, 2011 from http://gradworks.umi.com/33/46/3346431.html Murphy, E. (1997). Constructivism: From philosophy to practice. Retrieved on 9th February, 2011 from http://www.cdli.ca/~elmurphy/emurphy/cle.html Neal, K. (2007). Nurse-Patient relationships. Retrieved on 9th February, 2011 from http://www.nursing-practice.co.uk/docs/newCh5.pdf Nettina, S.M. (2006). Manual of Nursing Practice. (8th ed.). New York: Lippincott Williams & Wilkins. Somerville, D. and Keeling, J. (2004). A practical approach to promote reflective practice within nursing. Nursingtimes.net, 100(12), p.42. Retrieved on 9th February, 2011 from http://www.nursingtimes.net/nursing-practice-clinical-research/a-practical-approach-to-promote-reflective-practice-within-nursing/204502.article Woolfolk, A. E. (1993). Educational psychology. Boston: Allyn and Bacon. Wesley, R.l. (19950. Nursing theories and models. Springhouse, PA: Springhouse Corporation. Read More