- Email: [email protected]
Concept mapping for meaningful learning
Nurse Education Today (2004) 24, 41–46
Nurse Education Today intl.elsevierhealth.com/journals/nedt
Concept mapping for meaningful learning C. Akinsanya*, M. Williams Anglia Polytechnic University, Ashby House 3rd floor, Bishop Hall Lane, Chelmsford, Essex CM1 1SQ, UK Accepted 14 July 2003
KEYWORDS
Mapping; Concept; Relationships; Connections; Ideas; Learning; Hierarch; Analysis; Retention
Summary The complexity of teaching, learning and assessment strategies remains a problem in nurse education especially with the changes in new curricula. This article explains one solution, which was considered and explored prior to implementation for the assessment of an inquiry-based module in nurse education. The overall aim for selecting this method of assessment was to provide consolidation of prior learning from the core content of the module and to give the students an opportunity to gain further, wide and varied knowledge on a number of concepts in a short period. Concept mapping has proved to be one of the most challenging learning experiences for nursing students. It has been identified as a stimulating learning and assessing tool as predominantly acknowledged over the last year, by nursing students on the Inquiry-Based Learning (IBL) BSc and Dip HE nursing education programmes, and also nurse educators who have the responsibility of facilitating the learners. Crown Copyright c 2003 Published by Elsevier Ltd. All rights reserved.
Introduction This article relates to the introduction of concept mapping as a learning, teaching and assessment tool for one of the modules in the foundation programme of Inquiry-Based Learning (IBL) in the Diploma of Higher Education in Nursing and BSc Nursing courses. The adoption of IBL represents a change, which according to Elmore (1996) challenges the fundamental relationship between students, teachers and knowledge, and hence necessitates the quest for new learning, teaching and assessment strategies. A concept map can be viewed as ‘a schematic device for representing a set of concepts and meanings embedded in a framework of propositions’ (Novak and Gowin, 1984, p. 15). This is a strategy used by many tutors and facilitators to encourage deep learning. Concept mapping allows prior experience and under*
Corresponding author. E-mail address: [email protected] (C. Akinsanya).
standing to be taken into consideration when building new concepts into the perceptual framework. The next step in expanding the use of this Concept was to apply it as an assessment strategy.
The need for an innovative learning and assessing strategy For many years before and after State Registration was achieved by nurses in the United Kingdom 1919, the learner-employee status of the student nurse represented a particular form of apprenticeship training. This discouraged nurse educators from emphasising the aspects of teaching and learning related to the acquisition of knowledge, development of skills and appropriate attitudes which were not wholly service-led and determined. In today’s nurse education the favoured learning, teaching and assessment strategies are methods that are most effective in generating links between theory and practice. This is important for nurses in
0260-6917/$ - see front matter. Crown Copyright c 2003 Published by Elsevier Ltd. All rights reserved. doi:10.1016/S0260-6917(03)00120-5
42
their early education, as they can achieve clearer knowledge for good future clinical performance. A fundamental shift in the approach to nursing education was initiated by the recommendation of the Project 2000 Report (UKCC, 1986). One of its most important recommendations was that nursing education should be a part of higher education with student status as learners, thus ending the learneremployee dilemma, which had faced the profession since the Nurses Act of 1919. The implementation of the Project 2000 programme therefore represented a fundamental departure from the status quo and a change in the teaching and learning challenge to the nursing profession. As the Audit Commission noted in its report (National Audit Office, 1992): “It differs from the previous programme by placing more emphasis on wider aspects of health education, on the prevention of ill health and on community care”. Students are college-based and gain practical experience throughout the course on placements in hospital and community settings. (National Audit Office, 1992 – cited in Project 2000, p. 4) In terms of the educational philosophy underpinning Project 2000, the emphases on the relevant documentation are consistent with student-centeredness (mirrored in the holistic approach to patient care) and on integrating a range of subjects into nursing-focused courses. The shift in emphasis presented a considerable challenge to nurse educators and had important implications for teaching and learning approaches. This included the requirement for methods that were most suitable for producing nurses who met the changing needs of the National Health Service (NHS). For example, it could be argued that there is a need for a change to the education process for nurses so as to provide a curriculum to support primary health care initiatives. The content of the curriculum and the processes of learning would need to be carefully selected if educational institutions are to prepare nurses capable of practising within the primary health care context and thus respond satisfactorily to the challenges of nursing in the next century (Chamberlain and Beckingham, 1987; World Health Organisation, 1987 The new NHS Modern Dependable, 1997; NHS (Primary Care) Act, 1997). The response to this requirement for change is reflected in the altered accreditation arrangements following the implementation of Project 2000 and the accompanying changes in organisational structures, learning, teaching and assessment approaches and modifications in the design and content of nursing curricula. Since the early 1980s a number of authors have identified some of the difficulties clinical staff have experienced in fulfilling an effective educational
C. Akinsanya, M. Williams
role within nursing education (Fretwell, 1982; Marson, 1982; Ogier, 1981). The impact of the NHS & Community Care Act (1990) and reforms associated with the NHS over the last decade have radically altered its relationship with educational institutions in the education and training of nurses, midwives and health visitors. However given the close relationship between theory and practice and the difficulty experienced by teachers and learners in bridging the gap between the two, learning in nursing remains problematical (Howell, 1993; Schield, 1995; Jasper, 1995). At a time of strict economic stringency in education funding and the NHS (Swain, 1997; Thomas, 1997; The NHS Plan, 2000) it is clear that limited available resources is affecting the way in which learning, teaching and assessment are approached in nursing education. Currently in nursing education the issue of resources remains a challenging one, especially as the cohorts of nursing students are getting larger each year. The increased demand not only calls for the increase of mechanical resources, but also requires an increase in human resources. Hence the quest for new ideas in learning and teaching processes, including development of innovative student assessment strategies. When used as a learning strategy concept mapping allows for newer concepts to be subsumed under broader concepts, so the progress is typically from the known to the unknown. The formation of concept maps allows the concept to be externalised and related to prior understanding in order to make links between old and new concepts and create learning at a deeper level. For example, in learning a subject like anatomy and physiology, the links students make involve the organ and its functions as well as the relationship of organs and their systems so that they can understand how the body functions as a whole. The concept map strategy can also be used to bring together a number of known concepts under different single umbrella. For example, understanding the concept of management. This topic is generally tackled towards the end of the pre-registration programme. By this stage the students have covered the various issues that relate to management like communication, teamwork, group dynamics, motivation and other aspects within the module. By using these known individual concepts the students build an overall concept for management. The students are encouraged to analyse the links they are making to develop new understanding. Another use of concept mapping was encouraged when planning for assessment of a task, like a presentation, an essay or examination question. This method allows a student to put together what they wish to say as a coherent, complete and
Concept mapping for meaningful learning
comprehensive piece of work. It shows their understanding of the central concept and how connections are being made between contributing concepts (see Fig. 1). A Concept Mapping Poster presentation for the Inquiry-Based Learning Programme was implemented as the module assessment instead of a previously used approach. Which was adopted for the other modules within the curriculum as it proved to be a very resource intensive method. With the change in Diploma and BSc Nurse Education Course curricula, and the intake of extremely large cohorts, a number of assessment strategies were considered for the modules, some of whichwere related to presentation. However, the number of modules within the foundation programme meant that other methods of assessment were also needed to increase the variety of assessment techniques in use. Hence the introduction of new methods for assessing modules was encouraged. Appreciating assessment as an integral part of the learning process and concerns about the relationship between learning (as it occurred in nursing professional education) and professional practice, led to the suggestion of a concept map as the assessment method for this module and the idea was approved. As Crust (1996) proposed, learning involves change. It may reinforce as well as change a view or perspective. Acknowledging this and recognising that concept maps are ideal for measuring the growth of students, the module leader was convinced that it would encourage specific and purposeful learning, teaching and assessment as per
43
the module requirements. It must be noted that new strategies that bring changes to teaching, learning and assessment in nurse education shift power and responsibility from the teacher to the student as well as give confidence to the student. These factors all epitomise the requirements of effective learning. However, the learner should be confident to identify their learning needs. As Knowles (1984) suggested it must not be assumed that all learning must be through teacher-centred subject-based strategies. The Inquiry-Based Learning Curriculum hinges on the concept of legitimate peripheral participation and social cultural theories of learning (Williams and Wright, 2000). Learning within practice is therefore a matter of building up skills to become a fully functional member of the practice community (Wenger, 1998). The use of concept mapping for the process of learning has a complimentary approach in allowing the student to build on the existing knowledge from a core concept.
Concept mapping Concept maps have long provided visual languages and have been widely used in many different disciplines as formal knowledge representation systems. More generally, concept maps have been used in education as demonstrated by Novak and Gowin (1984) and Lambiotte et al. (1989). Concept mapping is a particularly good way of organising information related to a problem or subject. The construction of concept maps help us pull together
Figure 1 Example of concept map.
44
information we already know about a subject while integrating new information as we learn and expand our understanding. Hammond (1994) who proposes that concept mapping provides the learner with key schematic scaffolding to help them relate concrete examples to the conceptual structures and arguments within the field explored also supports this theory. Concept Maps are intended to represent meaningful relationships between concepts in the form of propositions. A concept map is a schematic device for representing a set of conceptual meanings embedded in a framework of propositions. It works to make clear to both students and teachers the small number of key ideas they must focus on for any specific learning task. A map can also provide a kind of visual road map showing some of the pathways we may take to connect meanings of concepts using propositions (Shavelson et al., 1994). After a learning task has been completed, concept maps provide a schematic summary of what has been learned. Because meaningful learning proceeds most easily when new perceptions are subsumed under broader, more an inclusive concept, concept maps should be hierarchical; that is, the more general to more inclusive. Concepts should be at the top of the map, with progressively more specific, less inclusive concepts arranged below (Martin, 1994). Although this was the original understanding of the design method, from observation during the concept map poster presentation, if students are allowed, they tend to be innovative in their design approaches. For example, the main concept can also be the core of the design without taking away the true meaning of concept mapping, and allows the student to explore different visual graphic formats that would help in retaining the information to be learned. Visual learning as identified by students on this course is essential for the student’s success in clarifying their thinking and to process, organise and prioritise new information, thus stimulating creative thinking allowing for understanding of the topic in greater depth. The issue of concept mapping leading to deep learning can be deduced through our understanding of the processes, which leads to deep learning (Atherton, 2002). Concept maps are ideal for measuring the growth of student learning as they reiterate ideas using their own words and any inaccuracies or incorrect links can alert the teacher to what the student does not understand. An awareness of the explicit role that language plays in the exchange of information is central to understanding the value and purpose of concept mapping. And, indeed, central to learning and educating (Novak and
C. Akinsanya, M. Williams
Gowin, 1984), especially as it is a way of representing or organising knowledge, showing relationships between concepts, including bi-directional relationships. Concept maps are effective tools for making the structure of knowledge explicit, and the hope is that by using them as one of the learning strategies the material will be more accessible and more easily integrated by students.
Facilitating the use of concept mapping as a learning and assessment strategy The evidence provided by the students shows that concept mapping allows for an organised approach to learning, from the known to the unknown, from the core concept to the subordinate, illustrating how knowledge can be organised for cognitive retention through an analytical approach. As now recognised by the facilitators participating in the module delivery, concept mapping provides excellent planning tools for making the process of knowledge explicit and easy to construct and integrate. As a result, the students are not only using concept mapping for this specific module assessment as a learning consolidation, but also as a learning tool for other learning tasks throughout the course. This includes planning of examination questions so as to maintain the logical sequencing of the conceptual relationships during the written examination, thus serving as an aide memoir which gives them a more positive approach to their knowledge retention. This change must be noted especially as this method of assessment is associated with an inquiry-based learning course where the students have more responsibility for their learning. Within the module guide the students were provided with examples of concept maps and guidelines were provided and discussed on what was expected for the concept map poster presentation. For the Concept Map Poster the students were required to utilise the information collected from their personal literature search to produce a well-structured concise description of one selected concept. This they would share with their peer group through a presentation of the concept map poster. During the planning and delivery stages they needed to give consideration to the learning outcomes, the core concepts of the module, and the IBL process, in relation to community and social care for an individual or a family, as these were the main themes of the module. The students were given guidelines that indicated that they were required to select one concept that was of interest to them, research the
Concept mapping for meaningful learning
topic fully, then prepare a poster to present for 15 min with peer group discussion at the end of delivery. During facilitation the students were made aware that the discussion time was included in the allotted time, and that they needed to consider this during planning. Because of the arrangement of the IBL curriculum, with the students working in small groups, instructions were given for each group member to select a different concept. This division of the task allowed for wide and varied learning of a number of concepts in a short period. This is another interesting aspect of concept mapping poster sharing for this module. Another facet that was introduced at this time for the concept map poster presentation was initiation of self-assessment. By using the marking criteria sheet provided within the module guide, the students were encouraged to self-assess as a form of self-appraisal, as evidenced by Black and Williams (1998). This self-assessment exercise was built in as a requirement of the module so as to allow the student to experience from an early stage in their education self-appraisal/evaluation skills. This is especially pertinent as it was going to be an important requirement in their professional life. Moreover, these requirements are based on the changes in professional practice and governmental health care policies. As caring professionals nurses are encouraged by the professional bodies and government policies to empower patients, reflect on practice, provide evidence-based practice and be appraised on their performance. It is therefore inevitable to have developmental processes like self-appraisal/ evaluation skills built in at an early stage of nurse education courses to allow the student to become familiar with the process. Once the students self-assess their presentation, during the moderation process the student marks are compared with the moderated marks given by the facilitators and feedback is given to the students on their attempt of self-assessment along with their unratified results. The reason for selfassessing was clearly given to the student in the module guide as suggested below. ‘Self-assessment is an important feature of IBL education/learning therefore it is essential to use strategies which facilitate interactive teamwork such as group tutorials, seminars or problem-based learning in small mixed groups to promote interprofessional and multi-cultural understanding. This learning together enhances professional togetherness in caring’. (Module Guide) As Boud (1988, p. 36) detailed “It is not simply a matter of teachers designing an assessment
45
scheme which they believe will help promote an independent approach to learning: students must believe this to be so and find that deep or autonomous strategy on their part is rewarded”. Directions were also given to the facilitators to take into consideration the students self-assessment prior to and during the moderation process, ensuring that they give constructive feedback that would help the student to build their skills, thereby contributing in their overall development as a health care professional.
Further examples of concept map implementation for learning and assessment Further examples of the use of concept mapping in the process of learning with this establishment can be summarised as: The module on management occurs within the final year of the pre-registration programme. From the content of the module and the specific outcomes it became clear that many of the concepts the student needed to understand about management had already been covered in earlier modules. For example, communication, interpersonal skills, team work and other facets had been covered on previous occasions. To go over the same ground again, even though from a slightly different perspective, would not generate enthusiasm and motivation for learning about management. However, there was a need to bring all the past learning into focus for the students to be able to integrate new learning and gain a holistic view of the concept of management. This was achieved through the use of concept mapping. First, a brainstorming session was held to identify all issues related to the concept of management. Then, students were asked to develop a concept map through group work. They were facilitated in this process through discussion and recognition of new connections among the issues identified, and reviewing their concept map. This process as a method of learning was well evaluated by the group. Learning and assessment using the concept map can be viewed in this example also: In a module called Life Long Learning Points the student has to incorporate the current learning related to professional development in order to achieve outcomes for the module and gain academic credits. One of the students was undertaking learning about the role of the Walk-In Centre Nurse as a part of development in the new role. To develop further understanding of the role we decided to use concept mapping. At the onset of the module the student formed the concept map of the Walk-In Centre Nurse
46
from her understanding of the role. Subsequently, the concept map was reviewed and amended. These amendments clearly showed a change in thinking and learning that had occurred. Thus, for the assessment the student used the pre and post-learning concept maps and highlighted the learning steps that had taken place. The feedback from the student on use of this approach, as well as from the second marker and external assessor were positive and encouraging in relation to future use of concept map as a tool for learning, teaching and assessment.
Conclusion Consideration of the theoretical issues underpinning the use of concept mapping, as explored in the content of this article, as well as reflecting on the observations of the students and teachers on the use of concept mapping over almost two years has enabled a review of its utility and acceptance. Overall the evidence highlights the many benefits of concept mapping as a learning, teaching and assessment tool. Evaluation shows that it provides a powerful method for assisting learning at the conceptual level. As this article shows, concept maps are effective tools for making the structure of knowledge explicit. Therefore, it is hoped that by sharing this information, educators will attempt to increase the use of concept mapping during curriculum planning. This learning, teaching and assessment approach will give the students an opportunity to participate in far a more comprehensive learning process that is very relevant to the professional practice requirements.
References Atherton, J.S., 2002. Learning and Teaching: Deep and Surface Learning [On-line], UK. Available from. Boud, D., 1988. Moving towards autonomy. In: Boud, D. (Ed.), Developing Student Autonomy in Learning, second ed. Kogan Page, London, pp. 17–39. Black, P., Williams, D., 1998. Inside the Black Box. Kings College, London. Chamberlain, M.C., Beckingham, 1987. Primary health care in Canada: In praise of the nurse. International Nursing Review 361 (6), 158–196. Crust, J., 1996. A relational view of learning implications for nurse education. Nurse Education Today 16, 256–266.
C. Akinsanya, M. Williams
Department of Health, 1997a. The New NHS; Modern, Dependable. HMSO, London. Department of Health, 1997b. NHS (Primary Care) Act 1997. The Stationary Office, London. Department of Health, 2000. The NHS Plan: A Plan for Investment, A Plan For Reform. The Stationary Office, London. Elmore, R.F., 1996. Getting to Scale with Good Educational Practice. In: Moon, B., Murphy, P. (Eds.), 1999 Curriculum In Contex. Paul Chapman, London, pp. 253–275. Fretwell, J.E., 1982. Ward Teaching and Learning. RCN, London. Hammond, N.V., 1994. Supporting learning from hypertext: concept-mapping and beyond. Computers and Education 22, 99–106. Howell, L., 1993. Sound learning-shared multi-site learning through NET audiobridge. Nurse Education Today 13, 441–444. Jasper, M., 1995. The portfolio workbook as a strategy for studentcentred learning. Nurse Education Today 15 (6), 446–451. Knowles, M.S., 1984. Andragogy in Action. San Francisco JosseyBass. Lambiotte, J.G., Dansereau, D.F., Cross, D.R., Reynolds, S.B., 1989. Multirelational semantic maps. Educational Psychology Review 1 (4), 331–369. Marson, S., 1982. Ward Sister-Teacher of Facilitator? An investigation into the behavioural characteristic of effective ward teachers. Journal of Advanced Nursing 7, 347–357. Martin, D.J., 1994. Concept mapping as an aid to lesson planning: a longitudinal study. Journal of Elementary Science Education 6 (2), 11–30. Nurses Act, 1919. HMSO, London. National Audit Office, 1992. Nursing Education: Implementation of Project 2000 in England. Report by the Comptroller and Auditor General. HMSO 291, London. NHS & Community Care Act, 1990. Novak, J.D., Gowin, D., 1984. Ogier, M.E., 1981. Ward Sister and their influence upon nurse learners. Nursing Times Occasional Paper 77 (11), 41–43. Schield, E., 1995. Reflection and learning in student nurses. Nurse Education Today 15, 452–458. Shavelson, R.J., Lang, H., Lewin, B., 1994. On concept maps as potential “authentic” Assessments in science (CSE Technical Report No. 388). National Centre for Research on Evaluation, Standards, and Students Testing (CRESST), UCLA, Los Angeles, CA. Swain, R., 1997. On the teaching and evaluation of experimental learning in a conventional university setting. British Journal of Educational and Technology 22, 4–11. Thomas, S., 1997. Developing the Primary Care led NHS. Journal of Community Nursing 11, 6–8. UKCC, 1986. A new Preparation of Practice. UKCC, London. Wenger, E., 1998. Communities of Practice, Learning, Meaning and Identity. Cambridge University Press, Cambridge. Williams, M., Wright, C., 2000. An action research on use of Inquiry Based Learning within the Teaching and Assessing Programme, Poster Presentation, NET Conference, September, Durham. World Health Organisation, 1987. Regulatory mechanisms for nursing training and practice: meeting primary health care needs. Conclusion and recommendations of WHO study group. International Nursing Review 34 (2), 52–54.
Nurse Education Today intl.elsevierhealth.com/journals/nedt
Concept mapping for meaningful learning C. Akinsanya*, M. Williams Anglia Polytechnic University, Ashby House 3rd floor, Bishop Hall Lane, Chelmsford, Essex CM1 1SQ, UK Accepted 14 July 2003
KEYWORDS
Mapping; Concept; Relationships; Connections; Ideas; Learning; Hierarch; Analysis; Retention
Summary The complexity of teaching, learning and assessment strategies remains a problem in nurse education especially with the changes in new curricula. This article explains one solution, which was considered and explored prior to implementation for the assessment of an inquiry-based module in nurse education. The overall aim for selecting this method of assessment was to provide consolidation of prior learning from the core content of the module and to give the students an opportunity to gain further, wide and varied knowledge on a number of concepts in a short period. Concept mapping has proved to be one of the most challenging learning experiences for nursing students. It has been identified as a stimulating learning and assessing tool as predominantly acknowledged over the last year, by nursing students on the Inquiry-Based Learning (IBL) BSc and Dip HE nursing education programmes, and also nurse educators who have the responsibility of facilitating the learners. Crown Copyright c 2003 Published by Elsevier Ltd. All rights reserved.
Introduction This article relates to the introduction of concept mapping as a learning, teaching and assessment tool for one of the modules in the foundation programme of Inquiry-Based Learning (IBL) in the Diploma of Higher Education in Nursing and BSc Nursing courses. The adoption of IBL represents a change, which according to Elmore (1996) challenges the fundamental relationship between students, teachers and knowledge, and hence necessitates the quest for new learning, teaching and assessment strategies. A concept map can be viewed as ‘a schematic device for representing a set of concepts and meanings embedded in a framework of propositions’ (Novak and Gowin, 1984, p. 15). This is a strategy used by many tutors and facilitators to encourage deep learning. Concept mapping allows prior experience and under*
Corresponding author. E-mail address: [email protected] (C. Akinsanya).
standing to be taken into consideration when building new concepts into the perceptual framework. The next step in expanding the use of this Concept was to apply it as an assessment strategy.
The need for an innovative learning and assessing strategy For many years before and after State Registration was achieved by nurses in the United Kingdom 1919, the learner-employee status of the student nurse represented a particular form of apprenticeship training. This discouraged nurse educators from emphasising the aspects of teaching and learning related to the acquisition of knowledge, development of skills and appropriate attitudes which were not wholly service-led and determined. In today’s nurse education the favoured learning, teaching and assessment strategies are methods that are most effective in generating links between theory and practice. This is important for nurses in
0260-6917/$ - see front matter. Crown Copyright c 2003 Published by Elsevier Ltd. All rights reserved. doi:10.1016/S0260-6917(03)00120-5
42
their early education, as they can achieve clearer knowledge for good future clinical performance. A fundamental shift in the approach to nursing education was initiated by the recommendation of the Project 2000 Report (UKCC, 1986). One of its most important recommendations was that nursing education should be a part of higher education with student status as learners, thus ending the learneremployee dilemma, which had faced the profession since the Nurses Act of 1919. The implementation of the Project 2000 programme therefore represented a fundamental departure from the status quo and a change in the teaching and learning challenge to the nursing profession. As the Audit Commission noted in its report (National Audit Office, 1992): “It differs from the previous programme by placing more emphasis on wider aspects of health education, on the prevention of ill health and on community care”. Students are college-based and gain practical experience throughout the course on placements in hospital and community settings. (National Audit Office, 1992 – cited in Project 2000, p. 4) In terms of the educational philosophy underpinning Project 2000, the emphases on the relevant documentation are consistent with student-centeredness (mirrored in the holistic approach to patient care) and on integrating a range of subjects into nursing-focused courses. The shift in emphasis presented a considerable challenge to nurse educators and had important implications for teaching and learning approaches. This included the requirement for methods that were most suitable for producing nurses who met the changing needs of the National Health Service (NHS). For example, it could be argued that there is a need for a change to the education process for nurses so as to provide a curriculum to support primary health care initiatives. The content of the curriculum and the processes of learning would need to be carefully selected if educational institutions are to prepare nurses capable of practising within the primary health care context and thus respond satisfactorily to the challenges of nursing in the next century (Chamberlain and Beckingham, 1987; World Health Organisation, 1987 The new NHS Modern Dependable, 1997; NHS (Primary Care) Act, 1997). The response to this requirement for change is reflected in the altered accreditation arrangements following the implementation of Project 2000 and the accompanying changes in organisational structures, learning, teaching and assessment approaches and modifications in the design and content of nursing curricula. Since the early 1980s a number of authors have identified some of the difficulties clinical staff have experienced in fulfilling an effective educational
C. Akinsanya, M. Williams
role within nursing education (Fretwell, 1982; Marson, 1982; Ogier, 1981). The impact of the NHS & Community Care Act (1990) and reforms associated with the NHS over the last decade have radically altered its relationship with educational institutions in the education and training of nurses, midwives and health visitors. However given the close relationship between theory and practice and the difficulty experienced by teachers and learners in bridging the gap between the two, learning in nursing remains problematical (Howell, 1993; Schield, 1995; Jasper, 1995). At a time of strict economic stringency in education funding and the NHS (Swain, 1997; Thomas, 1997; The NHS Plan, 2000) it is clear that limited available resources is affecting the way in which learning, teaching and assessment are approached in nursing education. Currently in nursing education the issue of resources remains a challenging one, especially as the cohorts of nursing students are getting larger each year. The increased demand not only calls for the increase of mechanical resources, but also requires an increase in human resources. Hence the quest for new ideas in learning and teaching processes, including development of innovative student assessment strategies. When used as a learning strategy concept mapping allows for newer concepts to be subsumed under broader concepts, so the progress is typically from the known to the unknown. The formation of concept maps allows the concept to be externalised and related to prior understanding in order to make links between old and new concepts and create learning at a deeper level. For example, in learning a subject like anatomy and physiology, the links students make involve the organ and its functions as well as the relationship of organs and their systems so that they can understand how the body functions as a whole. The concept map strategy can also be used to bring together a number of known concepts under different single umbrella. For example, understanding the concept of management. This topic is generally tackled towards the end of the pre-registration programme. By this stage the students have covered the various issues that relate to management like communication, teamwork, group dynamics, motivation and other aspects within the module. By using these known individual concepts the students build an overall concept for management. The students are encouraged to analyse the links they are making to develop new understanding. Another use of concept mapping was encouraged when planning for assessment of a task, like a presentation, an essay or examination question. This method allows a student to put together what they wish to say as a coherent, complete and
Concept mapping for meaningful learning
comprehensive piece of work. It shows their understanding of the central concept and how connections are being made between contributing concepts (see Fig. 1). A Concept Mapping Poster presentation for the Inquiry-Based Learning Programme was implemented as the module assessment instead of a previously used approach. Which was adopted for the other modules within the curriculum as it proved to be a very resource intensive method. With the change in Diploma and BSc Nurse Education Course curricula, and the intake of extremely large cohorts, a number of assessment strategies were considered for the modules, some of whichwere related to presentation. However, the number of modules within the foundation programme meant that other methods of assessment were also needed to increase the variety of assessment techniques in use. Hence the introduction of new methods for assessing modules was encouraged. Appreciating assessment as an integral part of the learning process and concerns about the relationship between learning (as it occurred in nursing professional education) and professional practice, led to the suggestion of a concept map as the assessment method for this module and the idea was approved. As Crust (1996) proposed, learning involves change. It may reinforce as well as change a view or perspective. Acknowledging this and recognising that concept maps are ideal for measuring the growth of students, the module leader was convinced that it would encourage specific and purposeful learning, teaching and assessment as per
43
the module requirements. It must be noted that new strategies that bring changes to teaching, learning and assessment in nurse education shift power and responsibility from the teacher to the student as well as give confidence to the student. These factors all epitomise the requirements of effective learning. However, the learner should be confident to identify their learning needs. As Knowles (1984) suggested it must not be assumed that all learning must be through teacher-centred subject-based strategies. The Inquiry-Based Learning Curriculum hinges on the concept of legitimate peripheral participation and social cultural theories of learning (Williams and Wright, 2000). Learning within practice is therefore a matter of building up skills to become a fully functional member of the practice community (Wenger, 1998). The use of concept mapping for the process of learning has a complimentary approach in allowing the student to build on the existing knowledge from a core concept.
Concept mapping Concept maps have long provided visual languages and have been widely used in many different disciplines as formal knowledge representation systems. More generally, concept maps have been used in education as demonstrated by Novak and Gowin (1984) and Lambiotte et al. (1989). Concept mapping is a particularly good way of organising information related to a problem or subject. The construction of concept maps help us pull together
Figure 1 Example of concept map.
44
information we already know about a subject while integrating new information as we learn and expand our understanding. Hammond (1994) who proposes that concept mapping provides the learner with key schematic scaffolding to help them relate concrete examples to the conceptual structures and arguments within the field explored also supports this theory. Concept Maps are intended to represent meaningful relationships between concepts in the form of propositions. A concept map is a schematic device for representing a set of conceptual meanings embedded in a framework of propositions. It works to make clear to both students and teachers the small number of key ideas they must focus on for any specific learning task. A map can also provide a kind of visual road map showing some of the pathways we may take to connect meanings of concepts using propositions (Shavelson et al., 1994). After a learning task has been completed, concept maps provide a schematic summary of what has been learned. Because meaningful learning proceeds most easily when new perceptions are subsumed under broader, more an inclusive concept, concept maps should be hierarchical; that is, the more general to more inclusive. Concepts should be at the top of the map, with progressively more specific, less inclusive concepts arranged below (Martin, 1994). Although this was the original understanding of the design method, from observation during the concept map poster presentation, if students are allowed, they tend to be innovative in their design approaches. For example, the main concept can also be the core of the design without taking away the true meaning of concept mapping, and allows the student to explore different visual graphic formats that would help in retaining the information to be learned. Visual learning as identified by students on this course is essential for the student’s success in clarifying their thinking and to process, organise and prioritise new information, thus stimulating creative thinking allowing for understanding of the topic in greater depth. The issue of concept mapping leading to deep learning can be deduced through our understanding of the processes, which leads to deep learning (Atherton, 2002). Concept maps are ideal for measuring the growth of student learning as they reiterate ideas using their own words and any inaccuracies or incorrect links can alert the teacher to what the student does not understand. An awareness of the explicit role that language plays in the exchange of information is central to understanding the value and purpose of concept mapping. And, indeed, central to learning and educating (Novak and
C. Akinsanya, M. Williams
Gowin, 1984), especially as it is a way of representing or organising knowledge, showing relationships between concepts, including bi-directional relationships. Concept maps are effective tools for making the structure of knowledge explicit, and the hope is that by using them as one of the learning strategies the material will be more accessible and more easily integrated by students.
Facilitating the use of concept mapping as a learning and assessment strategy The evidence provided by the students shows that concept mapping allows for an organised approach to learning, from the known to the unknown, from the core concept to the subordinate, illustrating how knowledge can be organised for cognitive retention through an analytical approach. As now recognised by the facilitators participating in the module delivery, concept mapping provides excellent planning tools for making the process of knowledge explicit and easy to construct and integrate. As a result, the students are not only using concept mapping for this specific module assessment as a learning consolidation, but also as a learning tool for other learning tasks throughout the course. This includes planning of examination questions so as to maintain the logical sequencing of the conceptual relationships during the written examination, thus serving as an aide memoir which gives them a more positive approach to their knowledge retention. This change must be noted especially as this method of assessment is associated with an inquiry-based learning course where the students have more responsibility for their learning. Within the module guide the students were provided with examples of concept maps and guidelines were provided and discussed on what was expected for the concept map poster presentation. For the Concept Map Poster the students were required to utilise the information collected from their personal literature search to produce a well-structured concise description of one selected concept. This they would share with their peer group through a presentation of the concept map poster. During the planning and delivery stages they needed to give consideration to the learning outcomes, the core concepts of the module, and the IBL process, in relation to community and social care for an individual or a family, as these were the main themes of the module. The students were given guidelines that indicated that they were required to select one concept that was of interest to them, research the
Concept mapping for meaningful learning
topic fully, then prepare a poster to present for 15 min with peer group discussion at the end of delivery. During facilitation the students were made aware that the discussion time was included in the allotted time, and that they needed to consider this during planning. Because of the arrangement of the IBL curriculum, with the students working in small groups, instructions were given for each group member to select a different concept. This division of the task allowed for wide and varied learning of a number of concepts in a short period. This is another interesting aspect of concept mapping poster sharing for this module. Another facet that was introduced at this time for the concept map poster presentation was initiation of self-assessment. By using the marking criteria sheet provided within the module guide, the students were encouraged to self-assess as a form of self-appraisal, as evidenced by Black and Williams (1998). This self-assessment exercise was built in as a requirement of the module so as to allow the student to experience from an early stage in their education self-appraisal/evaluation skills. This is especially pertinent as it was going to be an important requirement in their professional life. Moreover, these requirements are based on the changes in professional practice and governmental health care policies. As caring professionals nurses are encouraged by the professional bodies and government policies to empower patients, reflect on practice, provide evidence-based practice and be appraised on their performance. It is therefore inevitable to have developmental processes like self-appraisal/ evaluation skills built in at an early stage of nurse education courses to allow the student to become familiar with the process. Once the students self-assess their presentation, during the moderation process the student marks are compared with the moderated marks given by the facilitators and feedback is given to the students on their attempt of self-assessment along with their unratified results. The reason for selfassessing was clearly given to the student in the module guide as suggested below. ‘Self-assessment is an important feature of IBL education/learning therefore it is essential to use strategies which facilitate interactive teamwork such as group tutorials, seminars or problem-based learning in small mixed groups to promote interprofessional and multi-cultural understanding. This learning together enhances professional togetherness in caring’. (Module Guide) As Boud (1988, p. 36) detailed “It is not simply a matter of teachers designing an assessment
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scheme which they believe will help promote an independent approach to learning: students must believe this to be so and find that deep or autonomous strategy on their part is rewarded”. Directions were also given to the facilitators to take into consideration the students self-assessment prior to and during the moderation process, ensuring that they give constructive feedback that would help the student to build their skills, thereby contributing in their overall development as a health care professional.
Further examples of concept map implementation for learning and assessment Further examples of the use of concept mapping in the process of learning with this establishment can be summarised as: The module on management occurs within the final year of the pre-registration programme. From the content of the module and the specific outcomes it became clear that many of the concepts the student needed to understand about management had already been covered in earlier modules. For example, communication, interpersonal skills, team work and other facets had been covered on previous occasions. To go over the same ground again, even though from a slightly different perspective, would not generate enthusiasm and motivation for learning about management. However, there was a need to bring all the past learning into focus for the students to be able to integrate new learning and gain a holistic view of the concept of management. This was achieved through the use of concept mapping. First, a brainstorming session was held to identify all issues related to the concept of management. Then, students were asked to develop a concept map through group work. They were facilitated in this process through discussion and recognition of new connections among the issues identified, and reviewing their concept map. This process as a method of learning was well evaluated by the group. Learning and assessment using the concept map can be viewed in this example also: In a module called Life Long Learning Points the student has to incorporate the current learning related to professional development in order to achieve outcomes for the module and gain academic credits. One of the students was undertaking learning about the role of the Walk-In Centre Nurse as a part of development in the new role. To develop further understanding of the role we decided to use concept mapping. At the onset of the module the student formed the concept map of the Walk-In Centre Nurse
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from her understanding of the role. Subsequently, the concept map was reviewed and amended. These amendments clearly showed a change in thinking and learning that had occurred. Thus, for the assessment the student used the pre and post-learning concept maps and highlighted the learning steps that had taken place. The feedback from the student on use of this approach, as well as from the second marker and external assessor were positive and encouraging in relation to future use of concept map as a tool for learning, teaching and assessment.
Conclusion Consideration of the theoretical issues underpinning the use of concept mapping, as explored in the content of this article, as well as reflecting on the observations of the students and teachers on the use of concept mapping over almost two years has enabled a review of its utility and acceptance. Overall the evidence highlights the many benefits of concept mapping as a learning, teaching and assessment tool. Evaluation shows that it provides a powerful method for assisting learning at the conceptual level. As this article shows, concept maps are effective tools for making the structure of knowledge explicit. Therefore, it is hoped that by sharing this information, educators will attempt to increase the use of concept mapping during curriculum planning. This learning, teaching and assessment approach will give the students an opportunity to participate in far a more comprehensive learning process that is very relevant to the professional practice requirements.
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