Teaching Learning in Nursing - Assignment Example

Table of Contents Section 2 Section-2 5 Section-3 10 Section-4 13 Section This section deals with the SWOT Analysis on personal and advantages and disadvantages of each factor in Teaching Learning in Nursing SWOT analysis is required to maximize the learning outcomes through strategic management of learning process for knowledge acquisition. The SWOT analysis of mentor skills on a personal note: SWOT Strengths Weaknesses Good role model, Good listener, Motivator, Organized, Understanding, Experienced and Knowledgeable. Lack of confidence, Difficulty in criticizing, Delegating and unaware of what is expected of student To learn from appropriate training, Share information, Lifelong learning and professional development, Learning from other mentors Heavy work load, Lack of time to spend with students, Poor staffing, Lack of equipment, Lack of support and Learning environment Opportunities Threats The benefits of the above strengths are as follows: The Motivating skills of the teacher will encourage the students to learn during the teaching process. The Teacher being a role model draws full attention of the students to take hold of the session to inculcate and impart the knowledge through teaching. The listening skills of the teacher help the learner to listen and understand the difficulties of the students in learning and thus by helping in removing the learning barriers. The experience and Knowledge of the teacher Ensures the designed curriculum achieves the learning outcome. Provides flexibility for the student in building up credits in assessment Contributes to ease of progression and transfer of knowledge within and across the students Lack of Confidence results in poor delivery of the learning process and poor achievement of learning outcome Difficulty in criticizing hampers the learning process when constructive criticism is expected is really needed in building the process Non delegation of authorities will disturb the control in class room Unaware of what is expected of student is really a big disadvantage in achieving the learning process, where mutual understanding is highly required. Advantages of the Opportunities: The learning skills of the teacher will enhance the skills required Willingness towards professional development will enhance the professional development skills through training Sharing of information will facilitate the learning from other mentors "Learning with and from others similarly engaged is one of the basic tenets of action learning" (Weinstein 1985:39). "Associate Mentors are newly qualified nurses and midwives who have met the outcomes of stage one. Knowledge, skills and competence will normally be developed and assessed through work-based learning and they will be supervised, when acting as an associate mentor, by an experienced mentor. They will meet the requirements of clause 6 of the Code of Professional Conduct: Standards for conduct, performance and ethics" (NMC 2004:13). Risks of the threats: Lack of learning equipment, support, time and learning environment is a major hindrance to the skills up gradations and professional development. Lack of time results in poor management skills of the mentor "The clinical learning environment is a multidimensional entity with a complex social context" (Chan 2001:624). References: Stuart (2003) asserts that the differences in formal hospital ward environments and community learning environments are often overlooked. However, Moos (1974), cited by Chan (2001) suggests there are three basic dimensions to conceptualize all human environments; Chan (2001) used the above dimensions to develop a Clinical Learning Environment Inventory. The need to create more innovative strategies to assess the clinical learning environment is stressed. Chan D (2001) Development of an innovative tool to assess hospital learning environments Nurse Education Today 21, 624-631 Stuart, C.C. (2003) Assessment, Supervision and Support in Clinical Practice Churchill Livingstone: London Weinstein K (1995) Action Learning. A Journey in Discovery and Development Harper Collins: London Nursing and Midwifery Council (2004) Consultation on a standard to support learning and assessment in practice, NMC: London Section-2 This section examines the learning theories in the practical sessions of nursing care and medication to an elderly patient. Now let us examine Humanistic and Behaviorism approaches of learning in Nursing: Humanistic Approach of Learning: Nursing as a human science necessitates that aspects of the educational approach be humanistic. The humanistic aspect acknowledges the uniqueness and holistic nature of the person. It is directed toward the discovery of knowledge. Humanism is a school of thought that believes human beings are different from other species and possess capacities not found in animals (Edwords, 1989). Humanists, therefore, give primacy to the study of human needs and interests. A central assumption is that human beings behave out of intentionality and values (Kurtz, 2000). This is in contrast to the beliefs of operant conditioning theorists who believe that all behavior is the result of the application of consequences or to the beliefs of cognitive psychologists who hold that the discovery or the making of meaning is a primary factor in human learning. Humanists also believe that it is necessary to study the person as a whole, especially as an individual grows and develops over the lifespan. The study of the self, motivation, and goal-setting are also areas of special interest. Humanizing patterns of communication can be learned and can enhance the nurse's awareness of sensitivity to the client's state of being and of becoming. Relevancy of Humanistic approach of learning while Taking Blood Pressure in an elderly person: The purpose of nursing is to intervene to support, to maintain, and to augment the patient's state of health. In a given environment, if a critical life situation develops for a client, to the degree the nurse uses humanizing communication attitudes and patterns while applying the nursing process, to a similar degree will the health of the client tend to move in a positive direction. A human being functions as a unique, whole being responding openly to the environment. In a Blood pressure attack the patient will tend to feel recognized and accepted as a human being depending on the degree to which he/she receives humanizing communication from the care practitioners. The goal of the humanistic nurse in this situation is to break the communication cycle of dehumanizing attitudes and interaction patterns that may occur during the treatment like pain or stress, replacing these with attitudes and patterns that humanize. While measuring the Blood Pressure in a severe condition to an elderly person, the learning will meet the following objective propose by Gage and Berliner 1991 1. Promote positive self-direction and independence (development of the regulatory system); 2. Develop the ability to take responsibility for what is learned (regulatory and affective systems); 3. Develop creativity (divergent thinking aspect of cognition); 4. Curiosity (exploratory behavior, a function of imbalance or dissonance in any of the systems); and 5. An interest in the arts (primarily to develop the affective/emotional system). Skill development through Humanistic Learning: 1. Students will learn best what they want and need to know. 2. Knowing how to learn is more important than acquiring a lot of knowledge. 3. Self-evaluation is the only meaningful evaluation of a student's work. 4. Feelings are as important as facts. 5. Students learn best in a non-threatening environment. Giaconia and Hedges (1982) suggests that this approach is associated with the development of following skills: 1. Improved cooperativeness, creativity, and independence (moderate); 2. Increased positive attitudes toward teacher and school, creativity, adjustment, and general mental ability (slight); 3. Lower language achievement (negligible) and achievement motivation (moderate); 4. No consistent effect on math, reading, or other types of academic achivement; and 5. No consistent effect on anxiety, locus of control or self-concept. Interpersonal communication is the means by which the nurse becomes; increasingly sensitive to and aware of the Patient's state of being, of the dynamic relationship between the client and his or her environment, and of the client's potential. Behaviorism Approach of Learning in Nursing: Nursing is a practice discipline that necessitates that aspects of the educational approach be behaviouristic. Therefore, some interactive learning is directive and enables measurement of behavioral achievement within cognitive, psychomotor and affective domains. These behaviors provide the competencies that allow nursing care to be practiced safely. Behaviorism is a theory of animal and human learning that only focuses on objectively observable behaviors and discounts mental activities. Behavior theorists define learning as nothing more than the acquisition of new behavior. In essence three key assumptions underpin this view: Observable behaviour rather than internal thought processes are the focus of study. In particular, learning is manifested by a change in behaviour. The environment shapes one's behaviour; what one learns is determined by the elements in the environment, not by the individual learner. The principles of contiguity (how close in time two events must be for a bond to be formed) and reinforcement (any means of increasing the likelihood that an event will be repeated) are central to explaining the learning process. (Merriam and Caffarella 1991: 126) Relevancy to behaviorism learning while giving medication to a patient In terms of learning, according to James Hartley (1998) four key principles come to the force: Activity is important. Learning is better when the learner is active rather than passive. ('Learning by doing' is to be applauded). Repetition, generalization and discrimination are important notions. Frequent practice - and practice in varied contexts - is necessary for learning to take place. Skills are not acquired without frequent practice. Reinforcement is the cardinal motivator. Positive reinforcers like rewards and successes are preferable to negative events like punishments and failures. Learning is helped when objectives are clear. Those who look to behaviourism in teaching will generally frame their activities by behavioural objectives While treating through medication, behaviorism approach emphasizes on identifying conditioning operant for the treatment as a universal learning process. So the nurse checks for the disease arousal and relieving symptoms during medication and thus by learns the consequences of dosages. The positive and negative reinforcement techniques can be very effective in treatment of symptomatic disorders. There are two different types of conditioning, each yielding a different behavioral pattern: 1. Classic conditioning occurs when a natural reflex responds to a stimulus. The most popular example is Pavlov's observation that dogs salivate when they eat or even see food. Essentially, animals and people are biologically "wired" so that a certain stimulus will produce a specific response. 2. Behavioral or operant conditioning occurs when a response to a stimulus is reinforced. Basically, operant conditioning is a simple feedback system: If a reward or reinforcement follows the response to a stimulus, then the response becomes more probable in the future. For example, leading behaviorist B.F. Skinner used reinforcement techniques to teach pigeons to dance and bowl a ball in a mini-alley. Edwords, F. (1989). What is humanism Amherst, NY: American Humanist Association. Available online: http://www.jcn.com/humanism.html Gage, N., & Berliner, D. (1991). Educational psychology (5th ed.). Boston: Houghton, Mifflin. Gianconia, R., & Hedges, L. (1982). Identifying features of effective open education. Review of Educational Research, 52(4), 579-602. D.C. Phillips & Jonas F. Soltis, Perspectives on Learning, Chapter 3. Teachers College Press. Hartley, J. (1998) Learning and Studying. A research perspective, London: Routledge. Merriam, S. and Caffarella (1991, 1998) Learning in Adulthood. A comprehensive guide, San Francisco: Jossey-Bass. Section-3 Typically, a learning contract has three components. The first deals with the student's goals and objectives. The second component involves identification of the learning resources and activities to be used. The third and most important component is specification of the products, processes, and outcomes for evaluation and the criteria to be used in assessing them. Learning Contract do develop Psychomotor, Cognitive and Affective domains: Learning Needs Learning Outcomes Learning Resources & Strategies Evidence of Accomplishment of Objectives How Evidence will be Validated (Criteria and Means for Validating) Learn to Practice Consolidation skills Developing Psychomotor Skills- The teacher learner will be able to communicate effectively with the students about the clinical procedures Improving Speech skills By practicing more speech with tutors in special sessions Skill Performance Feed back on speech sessions by the tutor Learn to Practice comprehension in class room Developing Cognitive-learning - The teacher learner will be able to translate a health care problem given in technical or abstract phraseology into concrete or less abstract, more common phraseology. By practicing written and verbal consent of health care problem to present it in comprehensive way. This can be practiced by Special sessions with tutor as well as the mock class room demonstration Acknowledged by the development of problem solving skills of the students Tutor Feedback and Student response in problem solving Learn to Receive what students are expecting from the teacher by developing awareness of their needs Practicing Affective learning- The teacher learner will be aware of the aesthetic factors influencing the health care situation By using predefined questions to elicit the student needs regarding learning process during learning process. Practiced through controlled or selected teaching sessions with student feedback and developing the criteria to meet student satisfaction More Awareness of student needs and increased interaction during learning process Student feedback and student satisfaction criteria form. Fulfillment of designed course learning outcomes. The negotiated learning contract is potentially one of the most useful tools available to those interested in promoting flexible approaches to learning. A learning contract is able to address the diverse learning needs of different students and may be designed to suit a variety of purposes both on course and in the workplace. A learning contract is essentially an agreement negotiated between a learner and a staff supervisor to ensure that certain activities will be undertaken in order to achieve a learning goal and that specific evidence will be produced to demonstrate that goal has been reached. From the outset, the learner is encouraged to identify his or her own learning needs and to develop learning objectives and strategies consistent with those needs. The main advantage of a contract is that it can be tailored to suit the individual learner Advantages of Learning contract: Has a clear focus on the value of good teaching Support individualized learning and flexible learning Provides strategical support Enhance self-reflection, learning to learn and self-management Provide learners with clear goals and pathways for achieving these, based on their own learning needs Has responsive and knowledgeable staff Is flexible, adaptable; has healthy approach: not ossified Provides one-on-one assistance for teaching projects Provides safe (nonjudgmental and formative) place to take risks and maintains confidentiality Is open to and seeks faculty input The overall skill development through Learning Contracts is as follows (1) students are able to devise personally relevant learning experiences, (2) planning and self-reflection involved in contract formation fosters greater student self-awareness, (3) independent study prepares students for lifelong learning, and (4) undergraduates have an opportunity to work individually with faculty members. However, the mere usage of the technique does not automatically bring about this ownership and involvement. As Collins(1991) has pointed out, the contractual bargain is often one-sided, with all the obligations being on the side of the student, and none on the part of the teacher. The teacher does not even undertake unequivocally to award a pass mark to the resultant work: she will do so only if in her judgment it meets the required criteria. Disadvantages: Need to be carefully introduced Extra time required of faculty and the heavy demand placed on learning resources. Can be inflexible, i.e. not take account of changes in learner's need and goals May devalue collaborative learning Are no guarantee in themselves of satisfactory learning outcomes References: COLLINS M I (1991) Adult Education as Vocation London, Routledge Section-4 Reflective practice is associated with learning from experience, and is viewed as an important strategy for health professionals who embrace life long learning. The act of reflection is seen as a way of promoting the development of autonomous, qualified and self-directed professionals. Engaging in reflective practice is associated with the improvement of the quality of care, stimulating personal and professional growth and closing the gap between theory and practice. Conway (1994) identified that reflection is "a process of looking back on what has been done and pondering on it and learning lessons from what did or did not work the act of deliberation, when the practitioner consciously stops and thinks what should I do now" (page 78) Two types of reflection have been described Reflection in action means "To think about what one is doing whilst one is doing it; it is typically stimulated by surprise, by something which puzzled the practitioner concerned"(Greenwood, 1993). Reflection in action allows the practitioner to redesign what he/ she is doing whilst he/she is doing it. This is commonly associated with experienced practitioners. However, it is much neglected. Reflection on action is defined as: "The retrospective contemplation of practice undertaken in order to uncover the knowledge used in practical situations, by analyzing and interpreting the information recalled" (Fitzgerald, 1994pp67) We can see here that reflection on action involves turning information into knowledge, by conducting a cognitive post mortem. Reflective Model- Gibbs Reflective Cycle Gibbs (1988) reflective cycle is fairly straightforward and encourages a clear description of the situation, analysis of feelings, evaluation of the experience, analysis to make sense of the experience, conclusion where other options are considered and reflection upon experience to examine what you would do if the situation arose again. This cycle can be used for your reflective writing. Gibbs Framework for Reflection (Linked with the core skills of reflection) Stage 1: Description of the event Patient with asthmatic attack has been brought to the hospital, on wheel chair by the assistants. The assistants requested for the assistance of emergency doctor check up and emergency medication. I have taken the preliminary medical record of the patient and intimated to the emergency doctor. Upon Doctors intimation, I have arranged for the ward bed and instructed ward assistants to make a bed for the patient in the emergency ward. Stage 2: Feelings and Thoughts (Self awareness) I felt eager to administer treatment to the patient by looking at the anxiety of the patient's relatives and assistants. The patient condition is also seemed critical, so I spoke to the patient's relatives and also applied humanistic approach in treating the patient. I gave counseling to the patient's relatives and to the patient to ease the process of the treatment. And now I feel the approach I have made is good. Stage 3: Evaluation The Doctor administered emergency drugs and brought the patient to normal Conditioning. And in the midnight the patient again suffered with inhalation problem. Again I have intimated to the doctor. Stage 4: Analysis The first Process of treatment went well. I have taken exact care of the patient in treatment, record and approach Other medical professionals like doctors, ward assistants acted timely and rescued the life. Upon the appearance of breathing problem symptoms, even after drug administration, I failed to keep the confidence in place. Instead of administering the inhalation assistants like nebulizer, I again called for the doctor's assistance. I should have used my cognitive or behavioral skills upon the symptoms to give relief to the patient there itself. Stage 5: Conclusion (Synthesis) Though I was able to apply my humanistic learning skills, I failed to apply what I have learned through my cognitive/behavioral skills in treating the patients, though what occurred is a normal clinical problem. Stage 6: Action Plan Next time, while treating the patients with similar conditions, I will definitely use my skills in my purview, to facilitate the quality of care to the patient, without fail. I will administer nebulizer and oxygen, according to the doctor's prescription before taking the extra assistance from other roles. References: Conway J 1994 Reflection the art and science of nursing and the theory practice gap British journal of nursing 3 (1): 77-80 Fitzgerald M (1994): Theories of Reflection for learning IN Reflective Practice in nursing, A Palmer and S Burns (eds). Blackwell Scientific, Oxford. Gibbs, G.(1988) Learning by Doing: A Guide to Teaching and Learning methods. Oxford: Oxford Brookes University. Greenwood J (1993): Reflective practice a critique of the work of Argyris & Schon. Journal of Advanced Nursing 19 1183-1187 Schon D (1987) Educating the reflective practitioner Jossey Bass, San Francisco Read More