- Email: [email protected]
Renewing pride in teaching: Using theory to advance nursing scholarship
Nurse Education in Practice (2009) 9, 119–126
Nurse Education in Practice www.elsevier.com/nepr
Renewing pride in teaching: Using theory to advance nursing scholarship Sandra Carter
*
Centre for Nursing Studies, 100 Forest Road, St. John’s, Canada A1A 1E5 Accepted 10 October 2008
KEYWORDS
Summary Teaching is, by its very nature, a scholarly activity. However, in the seventeen years since Boyer articulated teaching as a key domain of nursing scholarship, its full scholarly value has yet to be realized. The inherent nature of teaching scholarship is evidenced through mechanisms designed to build ‘‘bridges of understanding’’. Teaching scholarship then advances nursing scholarship by its impact on nursing practice. Recognizing teaching practices as scholarship also demonstrates pride in teaching. This article demonstrates the scholarship of daily educational practice by describing how reflections on the teaching-learning relationship, associated role changes, and time impact the ‘‘bridges of understanding’’. Theoretical frameworks of learning partnerships, learner-centered teaching, and critical inquiry are brought to life when described in terms of actual course activities. This, in turn, demonstrates how teaching advances nursing scholarship. c 2008 Published by Elsevier Ltd.
Teaching scholarship; Teaching partnerships; Theory; Teaching–learning roles
Introduction Remember those moments? The moment you knew that the student had grasped the elusive concept because you recognized a lack of understanding and modified your approach. Remember the moment you saw the graduate maintain high standards as taught and in turn mentor a student or a new graduate? The search for these moments is what
* Tel.: +1 709 777 7347. E-mail address: [email protected]
1471-5953/$ - see front matter c 2008 Published by Elsevier Ltd. doi:10.1016/j.nepr.2008.10.003
brought many to nursing education and these are the moments that help sustain us. We must celebrate our daily work as scholarly activity. This is what drew many to education, and truly valuing it has to start within ourselves. We must then explicate the complexity of our day-to-day work as scholarship to ensure that our teaching receives the value it deserves. We instinctively know that nursing scholarship underlies each of the aforementioned teaching moments, and yet the challenge remains to translate this personal knowledge (Carper, 1978) into acceptable evidence of scholarship.
120 It is important to value both personal knowing and the diverse expression of knowledge (Estabrooks, 1998; Rentschler and Spegman, 1996). These factors are key components of knowledge development. There is concern that as nursing education moves into the university setting, the scholarship of teaching will be primarily equated with research and publication (Carr, 2007; Ludwick et al., 1998; Rolfe, 2007). A narrowed focus of teaching scholarship would devalue the teaching role and could distance teachers from that which nurtures excellence in teaching. Using Boyer’s broad conceptualization of scholarship, the Canadian Association of Schools of Nursing (CASN), defines scholarship of teaching as ‘‘the conveyance of the science and art of nursing from the expert to the novice, building bridges between the teacher’s understanding and the student’s learning’’ (CASN Position Statement Document, 2004). This definition embraces the essence of quality teaching and implies that evidence of this scholarship can be demonstrated in a variety of ways. In turn, teaching scholarship advances nursing scholarship by its impact on nursing practice. The critical thinking abilities and expert practice that graduate nurses display is influenced by their undergraduate teaching. This paper shall provide evidence of teaching scholarship by demonstrating how reflection as teaching scholarship was used in the development and implementation of a first year nursing communications course. This course is taught in the first semester of a four year BN program. It is designed to enable students to demonstrate professional caring and communicate in professional relationships. Lab experiences use an experiential model to enhance self-awareness, interpersonal skills, and group dynamics (Bayntum-Lees, 1993; Pugsley and Clayton, 2003; White et al., 2000; WilliamsPerez and Keig, 2002). Several communications labs have mini-writing components where students reflect upon their personal learning from the lab session, and relate the experience to course readings and future nursing care. However, teachers also utilize reflective practice in their teaching, and this reflective component may be the most undervalued yet critical component of teaching scholarship. A key component of the communications course is to facilitate student abilities to partner with clients. However, the student’s experience of partnering with clients arises from their experience of partnering with their teachers. We teach by example. First year nursing students learn about nurse– client relationships and roles within the context of the teacher–student relationship and roles. As such, teacher reflections that influence the part-
S. Carter nering actions between the teacher and the student are important because they can influence the development of professional nurses. The student who partners with the teacher for learning may be better able to partner with clients for health care. However, this process initially arises out of teacher reflection on theory in the context of personal teaching practice. This paper will first outline the author’s theoretical reflections on the teacher–student relationship and roles. These reflections, which are based on cited literature, demonstrate how theory influenced the author’s perspective on teaching partnerships. Theoretical reflections are based in the context of personal teaching experience. Since teacher–student roles are based on how the relationship is first conceptualized, both the relationship and roles are discussed separately. It is beyond the scope of this paper to perform a detailed analysis of these factors. Rather, selected aspects will be reviewed to help illustrate the complexity of teaching actions in the day-to-day scholarship of teaching. After the theoretical underpinnings are outlined to present the author’s perspective on the teacher–student relationship and roles, selected teaching activities shall be described to demonstrate how this teacher reflection influences class activities, and as such are both examples of teaching scholarship. Teacher reflection and resultant activities are ways in which ‘‘bridges of understanding’’ are built. Underlying this illustration is an understanding of how much of this scholarship may never be revealed through scientific research as it is currently applied.
Reflections on the teacher–student relationship The teacher–student relationship is the most fundamental component of teaching, akin to clientcentered practice in the nurse–client relationship. Critical reflection and linkage of theory to practice occur in the context of, and is supported by, the teacher–student relationship (Clark, 2005; Gillespie, 2005). The teacher must use critical reflection and theory in order to teach the student to use critical reflection and theory. Over time, this knowledge and skill is refined in both participants. Although necessary throughout the career of a teacher, the role of critical reflection for the teacher may be most evident when transitioning from a staff nursing role to a nurse educator role (teacher). While formal education is a key component to transition, support from experienced teachers
Renewing pride in teaching: Using theory to advance nursing scholarship during the critical reflection phase is vital to help ensure success. For example, reflection on unfolding educational practice, discussion with colleagues, and literature review leads the teacher to more fully understand and integrate such theoretical frameworks as learning partnerships and student-centered teaching. Equal partnerships between teachers and students have generally been promoted as something to strive for in nursing education (Gaines and Baldwin, 1996). However, this can be impractical in teaching situations, as both partners are not equal in nursing knowledge (Paterson, 1998; Tabak et al., 2003). Paterson suggests that rather than striving for equal partnerships we should be striving for equitable partnerships wherein individual knowledge and experience are valued appropriately. As partners, we should influence and bring out the best in each other (Clark, 2005). The teacher must use reflection to identify when and how to use personal nursing knowledge to assist the student find meaning in the student experiences. Bergum (2003) notes that ‘‘teaching and learning is not about delegating or sharing power as a commodity, but rather understanding authority in terms of the wisdom that comes from sharing the lived life’’ (p. 126). Part of ‘‘sharing the lived life’’ implies that the partnership changes over the course of a semester as well as over the nursing program itself. Beginning students may require more guidance and direct support in structuring their learning than senior students. Part of scholarship in teaching is in determining the student’s place on the continuum of independence, and designing activities to support and guide appropriately. The goal is to develop independent thinkers and lifelong learners who strive for excellence in practice. Another fundamental change in nursing education has been the change from a behaviouristic to a humanistic framework (Gillespie, 2002; Paterson, 1998; Rentschler and Spegman, 1996). This emancipatory move was initiated by a perceived shift in emphasis from a training model to an educational model of nursing education (Shovein et al., 2005). The behaviourist model has been equated with a teacher focus, and learning as that which can only be observed and measured. A humanistic model has been equated with a student focus and a renewed emphasis on the learning process. However, in actual practice, teaching-learning approaches do not necessarily fall into such neat categories. One must question whether an integrated perspective can be more useful than an all-or-none approach. A humanistic framework can provide an overriding principle for valuing the teacher–student relationship, and as such give guidance for structuring edu-
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cational policies and class activities. However, there are times when behaviouristic components are appropriate and may still fit within a humanistic framework. Examples would include the observance of sterile technique, maintenance of confidentiality, and the demonstration of critical thinking skills. A focus on student learning and individual learning process can be maintained, even when teacher expertise is used to develop behavioural outcomes. The key is to remain focused on student learning and to meaningfully include the student in the process. There is an art to teaching nursing, just as there is an art to bedside nursing. How the teacher balances and integrates holistic and behaviouristic approaches is part of the art of teaching. For example, the teacher must identify and nurture individual abilities when assisting the student to critically analyze the impact of trust in the nurse–client relationship (humanism). However, ultimately the teacher must evaluate the evidence of critical thinking ability as the student links the concept of trust to the nurse–client relationship (behaviourism). The fit between learning partnerships and student-centered teaching, as well as the application of broad theoretical frameworks using humanistic and behaviouristic principles are but some of the considerations that underlie the teaching role. These essential factors help determine the design and implementation of activities used to engage students.
Reflections on teacher–learner roles Maintaining an equitable relationship involves critically analyzing teacher–student roles and promoting role change over time. Teacher reflection on the literature of learning partnerships, studentcentered teaching, and humanistic/behaviouristic frameworks were discussed with colleagues and contextualized by several years of teaching experience. These reflections led to the categorization of role changes in the teacher–student relationship. These changes occurred during the course of a semester, as reflective writing was used to link theory to practice (Fig. 1). The teaching role moved from one of primarily support to one of primarily challenge as the student role progressed from one of primarily exploring experiences to one of demonstrating self-direction. By the end of the semester, students were expected to analyze and apply theory to practice at a year 1 level. Reflection on teaching experience and discussion with colleagues was required to level expectations.
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A) Getting Started Phase
B) Working With Expectations Phase –
– Student Role: Explore
& assimilation of literature
experiences –
Student Role: Deeper analysis
–
Teacher Role: Support
Teacher Role: Support & Challenge
C)
Demonstrating Results Phase –
Student Role: Demonstrate self-direction in analysis & application of theory to practice
–
Figure 1
Teacher Role: Challenge & Support
Role changes in the teacher–student relationship: Linking theory to practice using reflective writing.
The teacher partnered with students and individualized teaching to ensure that expectations were realistic and that students were assisted in developing the skills required to meet the expectations. The initial focus was to develop an atmosphere of trust and support in order to encourage the exploration and expression of ideas. The teacher provided a different perspective and posed questions to assist in making links to practice. Equity in the relationship meant that the teacher used expertise to increasingly challenge students while supporting their progress. At the end of the semester students were expected to demonstrate an increased ability to independently rise to the challenge, even though variations in abilities and growth patterns were recognized. Examples of how this was accomplished follows in the ‘‘activities’’ section. Although not illustrated in Fig. 1, the student role included challenging the teacher. As each participant was learning from each other, each participant was essentially both a teacher and a student. Reflections and observations of both participants lead to identifying and rethinking assumptions. However, for clarity purposes, the teacher in Fig. 1 refers to the faculty member. Students also challenged the teacher to individualize feedback. For example, feedback provided to the vulnerable student who had difficulty with expression differed from that provided to the more confident student. Gillespie (2002) would refer to this as being a ‘‘connected’’ teacher –– one who balances competence with compassion. A simultaneous layering occurred as the teacher used theory in practice in order to support the student to use theory in practice. Thus is the art and science of nursing education.
Activities influenced by reflections on relationships and roles Course activities arose from course goals and objectives, and started with structuring the relationship in such a way that the teacher was accountable for the curriculum content while incorporating student input into the process. The activities were consistent with the equitable relationship as previously described, and in and of themselves helped promote the relationship (Wilson and Summer, 2000). Dialogue provided opportunity for both participants to gain new insights into themselves, and how course concepts could be applied in the educational and clinical settings. Following is a description of selected lab activities that were used to assist students to link communication and caring theories to nursing practice. The ultimate goal was to promote professional caring (Lee-Hsieh, 2003). The activities are presented according to the stages of role changes as listed in Fig. 1 to show how activities relate to changing roles. How the teacher uses the constructs of learning partnerships, student-centered teaching, and humanistic–behaviouristic frameworks is evidenced to demonstrate the interrelationship between student links to nursing practice and teacher links to educational practice.
(A) Getting started phase Prior to the first lab day, students completed readings on experiential learning and had begun to discuss how reflective thinking of experiences could be used to improve their future nursing practice.
Renewing pride in teaching: Using theory to advance nursing scholarship Course expectations had been outlined and revised as necessary. In the first lab session, the students introduced and spoke a little about themselves. Students were then invited to write three sentences describing the experience of introducing themselves. The teacher role was to help create an atmosphere that encouraged reflection and expression of ideas (Fig. 1A). Writing expectations were limited so as not to overwhelm even the shyest of students. In return, the student was expected to be responsive to this type of learning. Faculty feedback was used to welcome and encourage expression. Fig. 2A shows the variation in student responses during the ‘‘getting started’’ phase as students described the experience of introducing themselves. The minority of students who at this time linked a course concept to their reflection (e.g. student 2) had this acknowledged and further encouragement was provided. Those students who did not link a course concept to their mini-writing reflection (e.g. student 1) were encouraged to do so. For example, written feedback for student #1 included a suggestion to reflect upon what it was about the smaller group that helped them speak (e.g. ability to see facial expression, welcoming faces etc.) and encouragement to relate this to future client nurse–client relationships. Care was taken to provide the feedback in a manner so as to nurture future responses. Such teacher analysis of individual learning and resultant choice of response has been described as the scholarship of teaching (Diekelmann, 2002). How and when feedback is provided arises from reflection on teaching practice. This process is refined over time and comprises part of the art of teaching as a critical component of teaching scholarship.
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used as a starting point and the teacher used expertise to identify where and how to help build ‘‘bridges of understanding’’. In this second phase of role changes (Fig. 1B), the student role included beginning a deeper analysis of ideas and attempting to link theory to practice. The teacher role was still primarily to support the expression of ideas, but also to challenge assumptions and inconsistencies. Students differed in their ability to analyze ideas (see Fig. 2B). Teaching scholarship involved recognizing the need for assistance and individualizing the teaching appropriately. For example, feedback provided was focused on encouraging student 1 to consider what was meant by ‘‘the same way’’, and the implications for future nursing practice. Feedback for student 2 acknowledged the identity of ‘‘intense feelings’’ and encouragement to reflect more deeply on how to listen to individual perspective was provided. While individual teacher feedback will likely differ, ultimately the task of ‘‘building bridges’’ is promoted as the variations in student abilities are recognized. Over time, the teacher becomes more adept at the art of providing appropriate individualized feedback. Essentially, the task is to use the teacher’s knowledge to building the bridges of understanding (CoyleRogers and Cramer, 2005) by making connections to the student’s experience (Bergum, 2003). Mini-writing pieces were included in several labs during the ‘‘working with expectations’’ phase. Lab participation grades were reflective of both verbal participation as well as the quality of critical thinking evident in written reflections throughout the semester.
(C) Demonstrating results phase (B) Working with expectations phase Later in the semester students used a written activity to explore their own values. Students were asked to use a likert scale to place the number which best explained their present position on such issues as the use of medical technology or following physicians orders. Group discussion helped identify core values and describe how the values could influence behaviours. Then students wrote about feelings arising from this activity and how personal core values could influence future interactions with clients. While the students had more knowledge about their personal feelings and beliefs, the teacher had more knowledge about how these feelings/beliefs may impact client care. An equitable relationship meant that student reflections were
Feedback on mini-writing sessions was used to nurture the ability to apply critical thinking skills. Students were expected to be more self-directed in the application of theory to practice by the concluding weeks of the semester. At that time, students selected a course concept which had significance for them based on a lab or class experience. They then wrote a paper relating the significance of this experience to the course concept. They selected, interpreted, and related nursing literature; both to the chosen concept and their personal experience. For example, a significant lab experience for a student may have occurred when sharing information related to their values. The student could then use the literature to relate this experience to the concept of trust, and further relate this experience to their future nursing care.
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B) Working with Expectations Phase
A) Getting Started Phase
Student 1: “I do not like to speak in class
Student 1: “Common sense tells us that all
but because the group was small, it was not
clients, regardless of differences, ought to
so bad”.
be treated the same way”.
Student 2: “When I spoke, people really
Student 2: “I had not realized just how
listened --- and that made me comfortable.
intense my feelings were about [these]
Comfort can lead to trust, which I think is
situations. I need to really make an effort
the basic thing needed to open up to
to listen to my patient’s individual
someone”.
perspective”.
Word count with reference list / figures = 4506 Word count without reference list / figures = 4315
Figure 2
Sample of student comments during the getting started and the working with expectations phases.
This is a fundamental way to link theory to practice. Another way for the student to link theory to practice could be to link Pepleau’s theory of relationship development to the significant lab (trust) experience and describe how the experience and critical reflection might impact upon their future nursing care. Linking broad concepts or a particular theorist’s work to future nursing care is a valuable form of linking theory to practice. Students were expected to utilize the feedback provided throughout the semester’s mini-writing sessions to enhance their critical thinking abilities and their ability to link theory to practice. During the ‘‘demonstrating results’’ phase, the teacher role was primarily to challenge the student to take more responsibility in identifying assumptions/ inconsistencies and to link theory to practice. Although support was still part of the teaching role, this was viewed as the time for students to demonstrate independent abilities. Equity in the teacher–student relationship is promoted by this approach. The process starts with a significant experience chosen by the student, the student is encouraged to consider feedback provided by the teacher in order to promote critical thinking, and then is expected to demonstrate an
enhanced level of critical thinking by the end of the semester. Such fundamental ways in which the teacher partners with students to promote student success should be included in the scholarship of teaching. Assisting students requires teachers to simultaneously layer the links of theory to practice. This process occurs on a daily basis. By assisting students to make links of nursing (and other) theories to clinical practice, teachers are concurrently linking educational (and other) theories to educational practice. This activity can be compared to juggling while roller-skating and exemplifies the true art of nursing education. It is refined over the course of a teacher’s career.
Conclusion Obtaining support for scholarship begins with recognizing that the reflections and actions involved in building the ‘‘bridges of understanding’’ constitutes scholarship of teaching. Merit as scholarship should rest on the relationship to educational goals, and ultimately by the critical thinking ability and professional caring displayed by graduates. Creativity must be used in describing how these
Renewing pride in teaching: Using theory to advance nursing scholarship bridges are built to ensure that all components are captured and that teaching is not marginalized. This article has presented how teacher reflection of role relationships influenced teaching practices, and as such provides evidence of teaching scholarship. Evidence of the scholarship of teaching could also include mentoring activities, development of a teaching portfolio, contributions to brainstorming sessions, literature review, and teacher reflections. Teachers are challenged to find additional ways to demonstrate how daily activities impact teaching practice and nursing care. Such review is important to maintain the time required to ensure that teaching remains the central function of nurse educators. We must take pride in our teaching by valuing our daily work as scholarship. Critical reflection on teaching practice, discussion and validation with colleagues, literature review, brainstorming, and resultant course development, implementation and evaluation take time. These actions happen concurrently, and are important for good teaching practice. However, excellence in practice requires a deliberate devotion to embracing, cherishing, and nurturing the time it takes to enhance our own teaching and learning. Kerfoot (2007) questions ‘‘Could it be that we can’t reinvent ourselves because we are too busy? Change doesn’t happen without thought’’ (p. 107). Reflections on, and changes to teaching practice can be greatly influenced by the time available for these endeavours. Teachers have difficulty balancing research, teaching, and practice responsibilities (Little and Milliken, 2007; Rolfe, 2007; Rolfe and Gardner, 2006; Thompson and Watson, 2006). Time spent on the scholarship of teaching practice can be translated into the development of nurses who strive for excellence in their nursing practice. If teaching is viewed as a sideline occurrence, then anybody can do it. However, if teaching is viewed in terms of the thought and the intricate balances involved, the art and science of teaching becomes evident. One only has to consider the effect that individualized teaching for one student can have on future clients to develop an appreciation of the skill inherent in teaching. It is not a career for just anyone. Teachers demonstrate a value for educational practice by acknowledging our daily work as teaching scholarship. Administration demonstrates value for educational practice by ensuring that time is available to keep teaching grounded in theory and practicality. This helps teachers sustain a passion for teaching. A passion for teaching brought many to nursing education. The scholarship of teaching must include meaningful recognition for the intricate bal-
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ances, veracity, and determination which makes it work. Although nothing can replace the moments when the teacher is acutely aware of the impact they have made, sometimes those moments are few and far between. Those moments alone can not sustain excellence in teaching practice. Scholarly recognition for the art as well as the science of nursing education is essential. Teacher reflection, and the simultaneous layering of educational and nursing theories, may be the most undervalued component of teaching. Yet they may be the most vital component of teaching practice. Recognition of daily teaching activities as the scholarship of teaching is required to ensure that teaching receives the value it deserves and that excellence in teaching practice is nurtured.
References Bayntum-Lees, D., 1993. Setting the scene for experiential learning. Nursing Standard 7 (36), 28–30. Bergum, V.B., 2003. Relational pedagogy. Embodiment, improvisation, and interdependence. Nursing Philosophy 4, 121– 128. Carper, B., 1978. Fundamental patterns of knowing in nursing. In: Nicoll, L. (Ed.), Perspectives on nursing theory. Scott Foresman, London, pp. 252–259. Canadian Association of Schools of Nursing, 2004. CASN Definition of Scholarship Position Statement Document. (accessed 28.03.08). Carr, G., 2007. Changes in nurse education: being a nurse teacher. Nurse Education Today 27, 893–899. Clark, C.S., 2005. Transforming nursing education: a partnership social system for alignment with philosophies of care. International Journal of Nursing Education Scholarship, 2(1).
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International Journal of Nursing Education Scholarship, 4(1). (accessed 18.04.08). Ludwick, R., Dieckman, B.C., Herdtner, S., Roche, M., Dugan, M., 1998. Documenting the scholarship of clinical teaching through peer review. Nurse Educator 23 (6), 17–20. Paterson, B., 1998. Partnership in nursing education: a vision or a fantasy? Nursing Outlook 46 (6), 284–289. Pugsley, K., Clayton, L., 2003. Traditional lecture or experiential learning: changing student attitudes. Journal of Nursing Education 42 (11), 520–523. Rentschler, D., Spegman, A., 1996. Curriculum revolution: realities of change. Journal of Nursing Education 35 (9), 389–393. Rolfe, G., 2007. Nursing scholarship and the asymmetrical professor. Nurse Education in Practice 7, 123–127. Rolfe, G., Gardner, L., 2006. Education, philosophy and academic practice. Nursing studies in the posthistorical university. Nurse Education Today 26, 634–639.
Shovein, J., Huston, C., Fox, S., Damazo, B., 2005. Challenging traditional teaching and learning paradigms: online learning and emancipatory teaching. Nursing Education Perspectives 26 (6), 340–343. Tabak, N., Adi, L., Eherenfeld, M., 2003. A philosophy underlying excellence in teaching. Nursing Philosophy 4, 249–254. Thompson, D.R., Watson, R., 2006. Professors of nursing: What do they profess? Nurse Education in Practice 6, 123–126. White, M.J., Kouzekanani, K., Olson, R., Amos, E., 2000. Outcomes of an experiential learning experience. Nurse Educator 25 (3), 121–123. Williams-Perez, K., Keig, L., 2002. Experiential learning: a strategy to teach conflict management. Nurse Educator 27 (4), 165–167. Wilson, C.B., Summer, 2000. Caring connections: self-disclosure of students’ stories to teachers in nursing. International Journal for Human Caring, 19–25.
Available online at www.sciencedirect.com
Nurse Education in Practice www.elsevier.com/nepr
Renewing pride in teaching: Using theory to advance nursing scholarship Sandra Carter
*
Centre for Nursing Studies, 100 Forest Road, St. John’s, Canada A1A 1E5 Accepted 10 October 2008
KEYWORDS
Summary Teaching is, by its very nature, a scholarly activity. However, in the seventeen years since Boyer articulated teaching as a key domain of nursing scholarship, its full scholarly value has yet to be realized. The inherent nature of teaching scholarship is evidenced through mechanisms designed to build ‘‘bridges of understanding’’. Teaching scholarship then advances nursing scholarship by its impact on nursing practice. Recognizing teaching practices as scholarship also demonstrates pride in teaching. This article demonstrates the scholarship of daily educational practice by describing how reflections on the teaching-learning relationship, associated role changes, and time impact the ‘‘bridges of understanding’’. Theoretical frameworks of learning partnerships, learner-centered teaching, and critical inquiry are brought to life when described in terms of actual course activities. This, in turn, demonstrates how teaching advances nursing scholarship. c 2008 Published by Elsevier Ltd.
Teaching scholarship; Teaching partnerships; Theory; Teaching–learning roles
Introduction Remember those moments? The moment you knew that the student had grasped the elusive concept because you recognized a lack of understanding and modified your approach. Remember the moment you saw the graduate maintain high standards as taught and in turn mentor a student or a new graduate? The search for these moments is what
* Tel.: +1 709 777 7347. E-mail address: [email protected]
1471-5953/$ - see front matter c 2008 Published by Elsevier Ltd. doi:10.1016/j.nepr.2008.10.003
brought many to nursing education and these are the moments that help sustain us. We must celebrate our daily work as scholarly activity. This is what drew many to education, and truly valuing it has to start within ourselves. We must then explicate the complexity of our day-to-day work as scholarship to ensure that our teaching receives the value it deserves. We instinctively know that nursing scholarship underlies each of the aforementioned teaching moments, and yet the challenge remains to translate this personal knowledge (Carper, 1978) into acceptable evidence of scholarship.
120 It is important to value both personal knowing and the diverse expression of knowledge (Estabrooks, 1998; Rentschler and Spegman, 1996). These factors are key components of knowledge development. There is concern that as nursing education moves into the university setting, the scholarship of teaching will be primarily equated with research and publication (Carr, 2007; Ludwick et al., 1998; Rolfe, 2007). A narrowed focus of teaching scholarship would devalue the teaching role and could distance teachers from that which nurtures excellence in teaching. Using Boyer’s broad conceptualization of scholarship, the Canadian Association of Schools of Nursing (CASN), defines scholarship of teaching as ‘‘the conveyance of the science and art of nursing from the expert to the novice, building bridges between the teacher’s understanding and the student’s learning’’ (CASN Position Statement Document, 2004). This definition embraces the essence of quality teaching and implies that evidence of this scholarship can be demonstrated in a variety of ways. In turn, teaching scholarship advances nursing scholarship by its impact on nursing practice. The critical thinking abilities and expert practice that graduate nurses display is influenced by their undergraduate teaching. This paper shall provide evidence of teaching scholarship by demonstrating how reflection as teaching scholarship was used in the development and implementation of a first year nursing communications course. This course is taught in the first semester of a four year BN program. It is designed to enable students to demonstrate professional caring and communicate in professional relationships. Lab experiences use an experiential model to enhance self-awareness, interpersonal skills, and group dynamics (Bayntum-Lees, 1993; Pugsley and Clayton, 2003; White et al., 2000; WilliamsPerez and Keig, 2002). Several communications labs have mini-writing components where students reflect upon their personal learning from the lab session, and relate the experience to course readings and future nursing care. However, teachers also utilize reflective practice in their teaching, and this reflective component may be the most undervalued yet critical component of teaching scholarship. A key component of the communications course is to facilitate student abilities to partner with clients. However, the student’s experience of partnering with clients arises from their experience of partnering with their teachers. We teach by example. First year nursing students learn about nurse– client relationships and roles within the context of the teacher–student relationship and roles. As such, teacher reflections that influence the part-
S. Carter nering actions between the teacher and the student are important because they can influence the development of professional nurses. The student who partners with the teacher for learning may be better able to partner with clients for health care. However, this process initially arises out of teacher reflection on theory in the context of personal teaching practice. This paper will first outline the author’s theoretical reflections on the teacher–student relationship and roles. These reflections, which are based on cited literature, demonstrate how theory influenced the author’s perspective on teaching partnerships. Theoretical reflections are based in the context of personal teaching experience. Since teacher–student roles are based on how the relationship is first conceptualized, both the relationship and roles are discussed separately. It is beyond the scope of this paper to perform a detailed analysis of these factors. Rather, selected aspects will be reviewed to help illustrate the complexity of teaching actions in the day-to-day scholarship of teaching. After the theoretical underpinnings are outlined to present the author’s perspective on the teacher–student relationship and roles, selected teaching activities shall be described to demonstrate how this teacher reflection influences class activities, and as such are both examples of teaching scholarship. Teacher reflection and resultant activities are ways in which ‘‘bridges of understanding’’ are built. Underlying this illustration is an understanding of how much of this scholarship may never be revealed through scientific research as it is currently applied.
Reflections on the teacher–student relationship The teacher–student relationship is the most fundamental component of teaching, akin to clientcentered practice in the nurse–client relationship. Critical reflection and linkage of theory to practice occur in the context of, and is supported by, the teacher–student relationship (Clark, 2005; Gillespie, 2005). The teacher must use critical reflection and theory in order to teach the student to use critical reflection and theory. Over time, this knowledge and skill is refined in both participants. Although necessary throughout the career of a teacher, the role of critical reflection for the teacher may be most evident when transitioning from a staff nursing role to a nurse educator role (teacher). While formal education is a key component to transition, support from experienced teachers
Renewing pride in teaching: Using theory to advance nursing scholarship during the critical reflection phase is vital to help ensure success. For example, reflection on unfolding educational practice, discussion with colleagues, and literature review leads the teacher to more fully understand and integrate such theoretical frameworks as learning partnerships and student-centered teaching. Equal partnerships between teachers and students have generally been promoted as something to strive for in nursing education (Gaines and Baldwin, 1996). However, this can be impractical in teaching situations, as both partners are not equal in nursing knowledge (Paterson, 1998; Tabak et al., 2003). Paterson suggests that rather than striving for equal partnerships we should be striving for equitable partnerships wherein individual knowledge and experience are valued appropriately. As partners, we should influence and bring out the best in each other (Clark, 2005). The teacher must use reflection to identify when and how to use personal nursing knowledge to assist the student find meaning in the student experiences. Bergum (2003) notes that ‘‘teaching and learning is not about delegating or sharing power as a commodity, but rather understanding authority in terms of the wisdom that comes from sharing the lived life’’ (p. 126). Part of ‘‘sharing the lived life’’ implies that the partnership changes over the course of a semester as well as over the nursing program itself. Beginning students may require more guidance and direct support in structuring their learning than senior students. Part of scholarship in teaching is in determining the student’s place on the continuum of independence, and designing activities to support and guide appropriately. The goal is to develop independent thinkers and lifelong learners who strive for excellence in practice. Another fundamental change in nursing education has been the change from a behaviouristic to a humanistic framework (Gillespie, 2002; Paterson, 1998; Rentschler and Spegman, 1996). This emancipatory move was initiated by a perceived shift in emphasis from a training model to an educational model of nursing education (Shovein et al., 2005). The behaviourist model has been equated with a teacher focus, and learning as that which can only be observed and measured. A humanistic model has been equated with a student focus and a renewed emphasis on the learning process. However, in actual practice, teaching-learning approaches do not necessarily fall into such neat categories. One must question whether an integrated perspective can be more useful than an all-or-none approach. A humanistic framework can provide an overriding principle for valuing the teacher–student relationship, and as such give guidance for structuring edu-
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cational policies and class activities. However, there are times when behaviouristic components are appropriate and may still fit within a humanistic framework. Examples would include the observance of sterile technique, maintenance of confidentiality, and the demonstration of critical thinking skills. A focus on student learning and individual learning process can be maintained, even when teacher expertise is used to develop behavioural outcomes. The key is to remain focused on student learning and to meaningfully include the student in the process. There is an art to teaching nursing, just as there is an art to bedside nursing. How the teacher balances and integrates holistic and behaviouristic approaches is part of the art of teaching. For example, the teacher must identify and nurture individual abilities when assisting the student to critically analyze the impact of trust in the nurse–client relationship (humanism). However, ultimately the teacher must evaluate the evidence of critical thinking ability as the student links the concept of trust to the nurse–client relationship (behaviourism). The fit between learning partnerships and student-centered teaching, as well as the application of broad theoretical frameworks using humanistic and behaviouristic principles are but some of the considerations that underlie the teaching role. These essential factors help determine the design and implementation of activities used to engage students.
Reflections on teacher–learner roles Maintaining an equitable relationship involves critically analyzing teacher–student roles and promoting role change over time. Teacher reflection on the literature of learning partnerships, studentcentered teaching, and humanistic/behaviouristic frameworks were discussed with colleagues and contextualized by several years of teaching experience. These reflections led to the categorization of role changes in the teacher–student relationship. These changes occurred during the course of a semester, as reflective writing was used to link theory to practice (Fig. 1). The teaching role moved from one of primarily support to one of primarily challenge as the student role progressed from one of primarily exploring experiences to one of demonstrating self-direction. By the end of the semester, students were expected to analyze and apply theory to practice at a year 1 level. Reflection on teaching experience and discussion with colleagues was required to level expectations.
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A) Getting Started Phase
B) Working With Expectations Phase –
– Student Role: Explore
& assimilation of literature
experiences –
Student Role: Deeper analysis
–
Teacher Role: Support
Teacher Role: Support & Challenge
C)
Demonstrating Results Phase –
Student Role: Demonstrate self-direction in analysis & application of theory to practice
–
Figure 1
Teacher Role: Challenge & Support
Role changes in the teacher–student relationship: Linking theory to practice using reflective writing.
The teacher partnered with students and individualized teaching to ensure that expectations were realistic and that students were assisted in developing the skills required to meet the expectations. The initial focus was to develop an atmosphere of trust and support in order to encourage the exploration and expression of ideas. The teacher provided a different perspective and posed questions to assist in making links to practice. Equity in the relationship meant that the teacher used expertise to increasingly challenge students while supporting their progress. At the end of the semester students were expected to demonstrate an increased ability to independently rise to the challenge, even though variations in abilities and growth patterns were recognized. Examples of how this was accomplished follows in the ‘‘activities’’ section. Although not illustrated in Fig. 1, the student role included challenging the teacher. As each participant was learning from each other, each participant was essentially both a teacher and a student. Reflections and observations of both participants lead to identifying and rethinking assumptions. However, for clarity purposes, the teacher in Fig. 1 refers to the faculty member. Students also challenged the teacher to individualize feedback. For example, feedback provided to the vulnerable student who had difficulty with expression differed from that provided to the more confident student. Gillespie (2002) would refer to this as being a ‘‘connected’’ teacher –– one who balances competence with compassion. A simultaneous layering occurred as the teacher used theory in practice in order to support the student to use theory in practice. Thus is the art and science of nursing education.
Activities influenced by reflections on relationships and roles Course activities arose from course goals and objectives, and started with structuring the relationship in such a way that the teacher was accountable for the curriculum content while incorporating student input into the process. The activities were consistent with the equitable relationship as previously described, and in and of themselves helped promote the relationship (Wilson and Summer, 2000). Dialogue provided opportunity for both participants to gain new insights into themselves, and how course concepts could be applied in the educational and clinical settings. Following is a description of selected lab activities that were used to assist students to link communication and caring theories to nursing practice. The ultimate goal was to promote professional caring (Lee-Hsieh, 2003). The activities are presented according to the stages of role changes as listed in Fig. 1 to show how activities relate to changing roles. How the teacher uses the constructs of learning partnerships, student-centered teaching, and humanistic–behaviouristic frameworks is evidenced to demonstrate the interrelationship between student links to nursing practice and teacher links to educational practice.
(A) Getting started phase Prior to the first lab day, students completed readings on experiential learning and had begun to discuss how reflective thinking of experiences could be used to improve their future nursing practice.
Renewing pride in teaching: Using theory to advance nursing scholarship Course expectations had been outlined and revised as necessary. In the first lab session, the students introduced and spoke a little about themselves. Students were then invited to write three sentences describing the experience of introducing themselves. The teacher role was to help create an atmosphere that encouraged reflection and expression of ideas (Fig. 1A). Writing expectations were limited so as not to overwhelm even the shyest of students. In return, the student was expected to be responsive to this type of learning. Faculty feedback was used to welcome and encourage expression. Fig. 2A shows the variation in student responses during the ‘‘getting started’’ phase as students described the experience of introducing themselves. The minority of students who at this time linked a course concept to their reflection (e.g. student 2) had this acknowledged and further encouragement was provided. Those students who did not link a course concept to their mini-writing reflection (e.g. student 1) were encouraged to do so. For example, written feedback for student #1 included a suggestion to reflect upon what it was about the smaller group that helped them speak (e.g. ability to see facial expression, welcoming faces etc.) and encouragement to relate this to future client nurse–client relationships. Care was taken to provide the feedback in a manner so as to nurture future responses. Such teacher analysis of individual learning and resultant choice of response has been described as the scholarship of teaching (Diekelmann, 2002). How and when feedback is provided arises from reflection on teaching practice. This process is refined over time and comprises part of the art of teaching as a critical component of teaching scholarship.
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used as a starting point and the teacher used expertise to identify where and how to help build ‘‘bridges of understanding’’. In this second phase of role changes (Fig. 1B), the student role included beginning a deeper analysis of ideas and attempting to link theory to practice. The teacher role was still primarily to support the expression of ideas, but also to challenge assumptions and inconsistencies. Students differed in their ability to analyze ideas (see Fig. 2B). Teaching scholarship involved recognizing the need for assistance and individualizing the teaching appropriately. For example, feedback provided was focused on encouraging student 1 to consider what was meant by ‘‘the same way’’, and the implications for future nursing practice. Feedback for student 2 acknowledged the identity of ‘‘intense feelings’’ and encouragement to reflect more deeply on how to listen to individual perspective was provided. While individual teacher feedback will likely differ, ultimately the task of ‘‘building bridges’’ is promoted as the variations in student abilities are recognized. Over time, the teacher becomes more adept at the art of providing appropriate individualized feedback. Essentially, the task is to use the teacher’s knowledge to building the bridges of understanding (CoyleRogers and Cramer, 2005) by making connections to the student’s experience (Bergum, 2003). Mini-writing pieces were included in several labs during the ‘‘working with expectations’’ phase. Lab participation grades were reflective of both verbal participation as well as the quality of critical thinking evident in written reflections throughout the semester.
(C) Demonstrating results phase (B) Working with expectations phase Later in the semester students used a written activity to explore their own values. Students were asked to use a likert scale to place the number which best explained their present position on such issues as the use of medical technology or following physicians orders. Group discussion helped identify core values and describe how the values could influence behaviours. Then students wrote about feelings arising from this activity and how personal core values could influence future interactions with clients. While the students had more knowledge about their personal feelings and beliefs, the teacher had more knowledge about how these feelings/beliefs may impact client care. An equitable relationship meant that student reflections were
Feedback on mini-writing sessions was used to nurture the ability to apply critical thinking skills. Students were expected to be more self-directed in the application of theory to practice by the concluding weeks of the semester. At that time, students selected a course concept which had significance for them based on a lab or class experience. They then wrote a paper relating the significance of this experience to the course concept. They selected, interpreted, and related nursing literature; both to the chosen concept and their personal experience. For example, a significant lab experience for a student may have occurred when sharing information related to their values. The student could then use the literature to relate this experience to the concept of trust, and further relate this experience to their future nursing care.
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B) Working with Expectations Phase
A) Getting Started Phase
Student 1: “I do not like to speak in class
Student 1: “Common sense tells us that all
but because the group was small, it was not
clients, regardless of differences, ought to
so bad”.
be treated the same way”.
Student 2: “When I spoke, people really
Student 2: “I had not realized just how
listened --- and that made me comfortable.
intense my feelings were about [these]
Comfort can lead to trust, which I think is
situations. I need to really make an effort
the basic thing needed to open up to
to listen to my patient’s individual
someone”.
perspective”.
Word count with reference list / figures = 4506 Word count without reference list / figures = 4315
Figure 2
Sample of student comments during the getting started and the working with expectations phases.
This is a fundamental way to link theory to practice. Another way for the student to link theory to practice could be to link Pepleau’s theory of relationship development to the significant lab (trust) experience and describe how the experience and critical reflection might impact upon their future nursing care. Linking broad concepts or a particular theorist’s work to future nursing care is a valuable form of linking theory to practice. Students were expected to utilize the feedback provided throughout the semester’s mini-writing sessions to enhance their critical thinking abilities and their ability to link theory to practice. During the ‘‘demonstrating results’’ phase, the teacher role was primarily to challenge the student to take more responsibility in identifying assumptions/ inconsistencies and to link theory to practice. Although support was still part of the teaching role, this was viewed as the time for students to demonstrate independent abilities. Equity in the teacher–student relationship is promoted by this approach. The process starts with a significant experience chosen by the student, the student is encouraged to consider feedback provided by the teacher in order to promote critical thinking, and then is expected to demonstrate an
enhanced level of critical thinking by the end of the semester. Such fundamental ways in which the teacher partners with students to promote student success should be included in the scholarship of teaching. Assisting students requires teachers to simultaneously layer the links of theory to practice. This process occurs on a daily basis. By assisting students to make links of nursing (and other) theories to clinical practice, teachers are concurrently linking educational (and other) theories to educational practice. This activity can be compared to juggling while roller-skating and exemplifies the true art of nursing education. It is refined over the course of a teacher’s career.
Conclusion Obtaining support for scholarship begins with recognizing that the reflections and actions involved in building the ‘‘bridges of understanding’’ constitutes scholarship of teaching. Merit as scholarship should rest on the relationship to educational goals, and ultimately by the critical thinking ability and professional caring displayed by graduates. Creativity must be used in describing how these
Renewing pride in teaching: Using theory to advance nursing scholarship bridges are built to ensure that all components are captured and that teaching is not marginalized. This article has presented how teacher reflection of role relationships influenced teaching practices, and as such provides evidence of teaching scholarship. Evidence of the scholarship of teaching could also include mentoring activities, development of a teaching portfolio, contributions to brainstorming sessions, literature review, and teacher reflections. Teachers are challenged to find additional ways to demonstrate how daily activities impact teaching practice and nursing care. Such review is important to maintain the time required to ensure that teaching remains the central function of nurse educators. We must take pride in our teaching by valuing our daily work as scholarship. Critical reflection on teaching practice, discussion and validation with colleagues, literature review, brainstorming, and resultant course development, implementation and evaluation take time. These actions happen concurrently, and are important for good teaching practice. However, excellence in practice requires a deliberate devotion to embracing, cherishing, and nurturing the time it takes to enhance our own teaching and learning. Kerfoot (2007) questions ‘‘Could it be that we can’t reinvent ourselves because we are too busy? Change doesn’t happen without thought’’ (p. 107). Reflections on, and changes to teaching practice can be greatly influenced by the time available for these endeavours. Teachers have difficulty balancing research, teaching, and practice responsibilities (Little and Milliken, 2007; Rolfe, 2007; Rolfe and Gardner, 2006; Thompson and Watson, 2006). Time spent on the scholarship of teaching practice can be translated into the development of nurses who strive for excellence in their nursing practice. If teaching is viewed as a sideline occurrence, then anybody can do it. However, if teaching is viewed in terms of the thought and the intricate balances involved, the art and science of teaching becomes evident. One only has to consider the effect that individualized teaching for one student can have on future clients to develop an appreciation of the skill inherent in teaching. It is not a career for just anyone. Teachers demonstrate a value for educational practice by acknowledging our daily work as teaching scholarship. Administration demonstrates value for educational practice by ensuring that time is available to keep teaching grounded in theory and practicality. This helps teachers sustain a passion for teaching. A passion for teaching brought many to nursing education. The scholarship of teaching must include meaningful recognition for the intricate bal-
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ances, veracity, and determination which makes it work. Although nothing can replace the moments when the teacher is acutely aware of the impact they have made, sometimes those moments are few and far between. Those moments alone can not sustain excellence in teaching practice. Scholarly recognition for the art as well as the science of nursing education is essential. Teacher reflection, and the simultaneous layering of educational and nursing theories, may be the most undervalued component of teaching. Yet they may be the most vital component of teaching practice. Recognition of daily teaching activities as the scholarship of teaching is required to ensure that teaching receives the value it deserves and that excellence in teaching practice is nurtured.
References Bayntum-Lees, D., 1993. Setting the scene for experiential learning. Nursing Standard 7 (36), 28–30. Bergum, V.B., 2003. Relational pedagogy. Embodiment, improvisation, and interdependence. Nursing Philosophy 4, 121– 128. Carper, B., 1978. Fundamental patterns of knowing in nursing. In: Nicoll, L. (Ed.), Perspectives on nursing theory. Scott Foresman, London, pp. 252–259. Canadian Association of Schools of Nursing, 2004. CASN Definition of Scholarship Position Statement Document.
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Shovein, J., Huston, C., Fox, S., Damazo, B., 2005. Challenging traditional teaching and learning paradigms: online learning and emancipatory teaching. Nursing Education Perspectives 26 (6), 340–343. Tabak, N., Adi, L., Eherenfeld, M., 2003. A philosophy underlying excellence in teaching. Nursing Philosophy 4, 249–254. Thompson, D.R., Watson, R., 2006. Professors of nursing: What do they profess? Nurse Education in Practice 6, 123–126. White, M.J., Kouzekanani, K., Olson, R., Amos, E., 2000. Outcomes of an experiential learning experience. Nurse Educator 25 (3), 121–123. Williams-Perez, K., Keig, L., 2002. Experiential learning: a strategy to teach conflict management. Nurse Educator 27 (4), 165–167. Wilson, C.B., Summer, 2000. Caring connections: self-disclosure of students’ stories to teachers in nursing. International Journal for Human Caring, 19–25.
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