Effective Approaches to Teaching in Nursing Education: From Didacticism to Facilitation, Study notes of Teaching method

Download Effective Approaches to Teaching in Nursing Education: From Didacticism to Facilitation and more Study notes Teaching method in PDF only on Docsity! Nurse Education Today, Volume 25, Issue 7, Pages 502-508 Approaches to teaching: current opinions and related research Published by Elsevier Maggi Banning , B.Sc. (Hons), M.Sc. PGDE, EdD, SRN, SCM. Approaches to Teaching The changing face of teaching has moved away from didacticism to learning facilitation and with this is the need for teachers to play different roles and use new techniques (Griffin, 2002, Jarvis, 2002). Three main styles of teaching are propounded; didactic, socratic and facilitative. The diversity of styles provides a degree of flexibility that allows one to alter the task of teaching whether it is teacher-centred or student-centred. Jarvis (2002) views teaching as both an art and a science. In doing so, one can combine the authoritarian didacticism approach with the democratic facilitator’s approach with no limit on the combinations. The lecture is “probably the most frequently employed teaching technique despite all the criticisms that have been levelled against it” (Jarvis, 1983 p 117). It is “an economical means of transmitting factual information to a large audience, although there is no guarantee that effective learning will result” (Walkin, 2000, p 55). The didactic approach to teaching primarily involves lecturing and is essentially teacher-centred (Entwistle, 1997). Fry, Ketteridge & Marshall (2003) reminds us that although the lecture remains a major method of teaching in adult and continuing education, and is still recognised “as a 1 Nurse Education Today, Volume 25, Issue 7, Pages 502-508 useful teaching tool” as it can provide a framework of ideas and theories but it needs to be complemented by interaction and adult-oriented strategies due to attention span and lack of participation. Didacticism raises numerous constraints which involve rote learning, learning by note taking, and potential boredom as the approach limits student participation and reflection. Many traditional lecturers continue to use the lecture as a means of teaching, especially when the subject is new to the majority of students or if the students are teacher dependent, anxious or disorganised as learners (Walkin, 2000). Radical pedagogies have challenged conventional classroom practice where the student is the recipient of new knowledge and the teacher is the knower. Teaching is “no longer seen as imparting knowledge and doing things to the student, but is redefined as facilitation of self-directed learning” (Tight, 1996, p 26). In an attempt to alter this position, the teacher can use problem-solving techniques and vicarious learning strategies to encourage students to articulate and theorize what they know already in relation to the meaning of their experiences and their interpretation (Preece & Griffin, 2002). Sharing of experiences allows students to critically think and undertake structured reflection on how the events may influence their personal circumstances. This facilitative approach to teaching teases out previous learning and helps students ‘make sense’ of experiences in relation to real world events (Gregory, 2002). Experiential learning reflects the ontology of the learner and can impact on both propositional and process knowledge forms 2 Nurse Education Today, Volume 25, Issue 7, Pages 502-508 awareness in students, initiate reflection and ponder on the key concepts. Both autocratic and non-autocratic teaching approaches equally enhance the ability of students to conceptualise and reflect on positions. Teaching scientific disciplines For more than a decade, the difficulty of teaching scientific theory to nurses has been debated. Key concerns focus on the variance in student comprehension, the disproportionate allocation of scientific and non-scientific subjects within curricula and the continual use of ineffective teaching strategies (McKee, 2002, Davies et al., 2000). The theory practice divide appears wider due to inappropriate clinical application (Tanner, 2000). This deficit contributes to the inadequate scientific preparation of nurses and a workforce that are unable to articulate the relevance of biological knowledge to clinical situations, or communicate scientific information to patients and their relatives (Clancy et al., 2000, Latter et al., 2000). Theoretical deficits in pharmacology are also apparent and require theoretical models to encourage improved teaching by nurse educators (Banning, 2003). My study explored the participants’ experience of teaching on an independent nurse prescribing course, findings indicated that knowledge transmission was the predominant teaching strategy used with little emphasis on the application of theory to practice. Self-directed study strategies were used as a back-up strategy even though students were provided with negligible academic support and guidance. In this situation, academic engagement of students was limited. Lecturers on this course needed to incorporate process oriented teaching strategies such as problem solving, case analysis, 5 Nurse Education Today, Volume 25, Issue 7, Pages 502-508 think aloud seminar and simulation to facilitate students learning of the scientific elements of prescribing (Banning, 2004). Teaching practical skills For learners undertaking vocational training, the skills to be taught should “resemble the real task, even if some of the distractions and complications of the real world have to be stripped away to lay bare the skeleton of the skill” (Rogers, 1989, p 49). When the skills to perform a specific job are based on a selective foundation, these skills are referred to as competencies and “the qualification will be based on competencies” (Rogers, 1989, p 50). In order for a learner to acknowledge and understand a specific skill it must be dissected into sub-components so that the learner can visualise the importance and relevance of each component. Students must be able to practice each sub-component of the skill and visualise its relevance. Practice allows the learner to reinforce the skill (Laurillard, 1997). Addressing students’ needs In every classroom, one may find people of mixed ability; how can the teacher meet the learning needs of all students? Rogers (1989) relates the need to break away from one- pace teaching to use flexibly-paced, multi-resourced learning strategies, also by setting clear objectives and ensuring that everyone meets these using a set standard to indicate achievement. Initially, the teacher needs to explore who the students are in the group, set 6 Nurse Education Today, Volume 25, Issue 7, Pages 502-508 out the housekeeping rules for the class group and objectives for teaching on the course. It is important to relax the students and allow students to set their own learning objectives and later involve them in project work to support their learning (Gosling, 2003). Brookfield, (1996) provides a summary of the components of students’ learning needs and explores how to implement an environment conducive to learning. He suggests that students’ learning needs can be met when teaching is facilitative rather than didactic and when the teacher acknowledges the learning needs, past experiences, relevant application and individual styles of learning of students when designing learning activities. Findings from my study on the student experience of studying to become independent nurse prescribers support these considerations (Banning, 2004). Students’ conceptions of adult learning involved the need to comprehend the relevance of theory in order to apply and assimilate it and also to be offered opportunities to share vicarious experiences with peers. The exploration of students’ views revealed the need for constructivist teaching methods (Hendry et al., 1999), rather than knowledge transmission to teach the applied pharmacology component of the course (Banning, 2004). Assessing learning within classroom situations Laurilliard (2002) reminds us that students attend courses with their individual presage variables. These variables provide some insight on the subtle differences that illustrate the uniqueness of each adult learner. These variables include; motivation, expectations, knowledge retention in relation to short and long term memory, knowledge, skills, 7 Nurse Education Today, Volume 25, Issue 7, Pages 502-508 personal characteristics and therefore fail to sufficiently engage in deep learning, often due to devaluation of the benefits of education (Hufton et al., 2002). Preparing students for new roles and responsibilities To prepare learners for new roles and responsibilities they need to acquire both professional and university education to develop professional performance. To become an experienced clinician who is proficient in clinical reasoning, a nurse has to attain specific clinical practice and develop nursing judgment, supported by a graduate academic background (O’Neill & Dluhy, 1997). This combination can provide a foundation for cognitive and psychomotor skill development that is essential for proficient clinical reasoning (Cooke & Moya, 2002). Although clinical reasoning is the hallmark of the nursing expert (Davies & Hughes, 1995), the debate on the sub-components of it continues (Flower, 1997). Proposed sub- components include reflection, critical thinking, diagnostic reasoning, nursing experience and nursing judgment. Reflection can be construed as a cognitive processing aspect of critical thinking (O’Neill & Dluhy, 1997); thus, it is an important skill. Reflection can be achieved by structured processing of experiences and teacher–centred problem-solving exercises (Seymour et al., 2003, Liimatainen et al., 2001). Students can reiterate “significant experiences of learning to others which is itself a reflective way for both the teller and the audience to learn more about the experience by interactively weaving together theory and practice with humane threads” (Cortazzi et al., 2001, p257). 10 Nurse Education Today, Volume 25, Issue 7, Pages 502-508 The students’ learning of new roles needs to be assessed both theoretically and clinically. The value of the assessment can only be as a credible as the individual assessor (While, 1994). Clinical assessors need to be familiar with assessment strategies, professional roles and guidance and instruction on the assessment and mentoring of students (Myrick & Yonge, 2001). Networking strategies can also be a useful support (Watkins, 2000, Duffy & Watson, 2001). The inclusion of multiple forms of assessments would help students integrate, synthesize and assimilate the theoretical components of the new roles with the clinical application and practical skills involved. This approach is valuable as it would not only incorporate strategies to promote critical thinking but would also be a powerful tool to assess the overall performance and ability of students to clinically reason and can serve as a safety net if performance is below average in any assessment. Opportunities should be available for students who fail an assignment to demonstrate that with increasing nursing experience and consolidation of theory with practice, academic and clinical performance can improve. Moreover, this approach can encourage the student to problem-solve, undertake team work, learn from peers, enhance the integration, synthesis and conceptualization of knowledge (Cooke & Moya, 2002). An important aspect of professional competency is feedback on clinical performance and this is a requisite indicator for learner development and confidence building. Ideally, students should be provided with feedback on clinical performance. The feedback 11 Nurse Education Today, Volume 25, Issue 7, Pages 502-508 sandwich is a useful approach to communicate performance (Glover, 2000). Clinical assessors should be encouraged to utilize this method with students. The experience of learning and achievements encountered can be reflected on and a narrative account provided (Gallacher, 2001). The narrative can then be used to assess the students’ clinical reasoning skills in particular their cognitive skills, critical thinking or situation-bound thinking and personal reflection (Fowler, 1997). Conclusion Three approaches to established, each has its own merits and usefulness in adult learning. The use of didactic and self directed approaches to teaching should be limited and approaches that are student-centred such as process oriented approaches to teaching should be encouraged particularly in teaching scientific topics, questioning and preparing nurses for prescribing roles. Learning facilitation should be encouraged with effective preparation strategies in place to train lecturers to effectively use these methods. References Banning, M, (2003). Pharmacology Education: A theoretical framework of applied pharmacology and therapeutics. Nurse Education Today,23: 459-466. Banning, M. (2004). An illuminative evaluation of the teaching and learning experience of participants’ teaching and studying on an independent nurse prescribing course. Unpublished EdD thesis. 12