Teaching and Learning Strategies

The premise of analogy as a teaching strategy is to make the unfamiliar familiar. Analogy is defined as a likeness or similarity between two things that are otherwise unalike. Analogy enhances an understanding of complex concepts or abstractions by allowing learners to consider the concepts in a different context. This learning strategy can be used in a variety of settings (classroom, clinical, Web) and can be used with large groups, small groups, or as an individual assignment.

Example of Using an Analogy (Video)

In order to view the example below, you will need Windows Media Player installed on your computer and speakers or headphones for your computer. See Information on downloading and using Windows Media Player.

Watch Video

Developing and Implementing Analogy as a Teaching Strategy

It is important to point out that that there are several ways this learning activity can be done; the level of the learner and the desired time spent on task are variables that should be considered. Some sources describe drawing an analogy from everyday life experiences; a higher level activity requires learners to use non-nursing literature to draw comparisons. Regardless of the method used, the basic following steps are followed:

Phase I: Substantive Input
The instructor must clearly frame the content of study conceptually. This may be done as a classroom presentation, discussion, or through written materials provided to the student.

Phase II: Analogy
The learners draw analogies that represent the concepts. Students should be able to compare analogies to the concepts by explaining how they are similar, but also how they are different.

Phase III: Concept Summarization
Students should summarize the connections made either in discussion groups, or in writing. A fun way to do this is to ask the student to write a story (using the analogy) to explain the concept, and are then shared with other students.

Advantage

• Is an active learning strategy
• Stimulates critical thinking
• Does not require a great deal of preparation
• Facilitates learning of complex concepts

Disadvantage

• This activity does not appeal to all students; some will not want to participate, and may consider the activity a waste of class time.
• Some students have difficulty making connections in a meaningful way.
• Use of literature for analogy can be difficult and time consuming.

A case study involves an analysis of a clinical situation or incident. This widely used teaching strategy usually depicts an actual or fictitious patient in a clinical situation, thus allowing students to learn concepts and diagnostic reasoning in a clinical context. Case studies can range from very simple to complex. Typically, a case study presents patient information followed by questions. The learner must analyze and interpret the data provided to answer questions. Critical thinking occurs when questions involve problem solving as opposed to interpretation of facts – in other words when questions posed are at an application, analysis, or evaluative level.

Example of Using a Case Study(Video)

In order to view the example below, you will need Windows Media Player installed on your computer and speakers or headphones for your computer. See Information on downloading and using Windows Media Player.

Watch Video

Developing and Implementing a Case Study Activity

Planning
The instructor must determine the goal of learning for the case study (i.e. what type of clinical situation is desired). Because there are several published case studies available, the planning may involve finding a case study appropriate for the desired learning. If the instructor elects to write a case study, it should include a patient situation within a specific setting and should include desired data (such as laboratory results, examination findings, medications, etc). The complexity of the case should be based on a) the level of the students, and b) the amount of time the instructor expects the students to work on the case study.

Implementation
The instructor needs to decide if this is an individual assignment or a group activity, and if this is to be an in class activity, or an out of class assignment. If the case study is to be an in class assignment, the instructor should be sure to provide initial instructions to the students, and allow them to work. The role of the instructor is to facilitate the work by discussing various points or options posed by the questions.

Evaluation
Instructors should provide feedback to the students so they can evaluate their thinking process. Evaluation can be done in a classroom setting (such as a discussion) or in writing if the case study was completed as an assignment.

Advantage

• Stimulates critical thinking through analysis and interpretation of data
• Presents nursing concepts in a clinical context that students can relate to
• When done in small groups, generates discussion and sharing of ideas and thoughts among group members
• Can be applied in multiple settings.
• Can be done in multiple formats (written, video, computer)
• Professionally written case studies are readily available in multiple formats

Disadvantage

• Development of a case study requires clinical expertise and is time intensive.

Debate involves the construction of argument to defend a position. This is an excellent critical thinking teaching strategy because it requires reasoning skills, analysis of multiple relationships, and consideration of multiple perspectives. This teaching strategy is best applied to topics involving controversy or dilemma particularly ethical or legal problems.

Example of Using a Debate (Video)

In order to view the example below, you will need Windows Media Player installed on your computer and speakers or headphones for your computer. See Information on downloading and using Windows Media Player.

Watch Video

Developing and Implementing a Debate Activity

1. The faculty member introduces the topic or problem.
2. Teams are formed (usually 2-3 per team); each team commits to defending or arguing for one side or the other.
3. Teams prepare a defense or argument for their position – ideally, this is done based on information from the literature. Debate preparation requires students to be able to articulate their position, and argue against the opposing position – thus students must be well prepared on both sides of the argument. The amount of time for preparation should depend on the type of problem posed. Preparation is often done as an out of class assignment for the following class period.
4. The debate occurs after the teams have had preparation time. The debate process includes opening arguments, presentation of viewpoints, rebuttal, and summary.
5. Discussion after the debate may be done to explore how the debate process changed the thinking of the students involved.

Advantage

• Argument/debate broadens the viewpoint of controversial topics
• Develops analytical skills
• Develops communication skills (required to present argument)

Disadvantage

• Requires time to develop argument – inadequate time for preparing argument defeats the purpose of this learning activity
• Requires an understanding of the debate format (faculty and students)

Jigsaw is a cooperative learning strategy that involves group learning. The name “Jigsaw” is given for the structure of activity within the group. Each group is given a task or problem within a packet of information. Within the group, each member is given one part of the packet (a “piece of a puzzle”) to learn. Each member then shares what they have learned with other group members – the goal is that all group members eventually learn all the information within the packet, but with the help of group members. The group depends on each individual in order to accomplish the task.

Example of Using a Jigsaw Activity (Video)

In order to view the example below, you will need Windows Media Player installed on your computer and speakers or headphones for your computer. See Information on downloading and using Windows Media Player.

Watch Video

Developing and Implementing Jigsaw

Preparatory work
The instructor must identify a problem or task for the group to accomplish. The instructor must then develop packets of information needed to accomplish the task. Within the packet, the information is divided into 4 or 5 parts – so that each group member will have a different part of the whole package. It is best to label each of these parts (i.e. #1, #2, #3, #4). Instructor should also attempt to make each of these parts equitable.

Implementation
Students are divided into working groups (4-5 per group) with general instructions. Packets are distributed to the group; group members each take one part of the packet.

• Phase I: Each member studies their individual part of the packet – the instructor needs to consider an appropriate amount of time for this initial work phase.
• Phase II: Each member discusses/teaches their specific information to other group members.
• Phase III: Group members complete the task.

Advantage

• Stimulates discovery learning and critical thinking
• Active learning process

Disadvantage

• Preparation of group packets is time intensive.
• Students may be initially unhappy with strategy; they may feel they are doing all the work, and expect that role from the instructor.
• Instructors often anxious about not covering “content”

References

Daley, B.J., Shaw, C.R., Ballistrieri, T., Glasenapp, K., Piacentine, L. (1999). Concept maps: A teaching strategy to teach and evaluate critical thinking. Journal of Nursing Education, 38, 42-47.

Wheeler, L.A., Collins, S. (2003). The influence of concept mapping on critical thinking in baccalaureate nursing students. Journal of Professional Nursing, 19, 339-346.

Problem based learning (PBL) is a teaching strategy that involves group problem solving with real-life situations (case or scenario) that stimulates critical thinking. True PBL learning also is a process of discovery in that students learn concepts/content by working through the activity – in other words the content is self-taught by the group. PBL is always done as small group work, and occurs over more than one class session. Introductory information is briefly presented describing the situation but the problem is not readily defined. It is up to the learners within a group to identify key issues, and determine what additional information is needed. Through the process of discussion and discovery, the group arrives at solutions to the problem.

Example of Problem-Based Learning (Video)

In order to view the example below, you will need Windows Media Player installed on your computer and speakers or headphones for your computer. See Information on downloading and using Windows Media Player.

Watch Video

Developing and Implementing Problem Based Learning

To begin a PBL session, students are divided into several small groups (groups of 5 is ideal) and presented with a problem.

1. Students in groups first discuss the problem and brainstorm as to what the key concepts are in the problem.
2. Group identifies a) what is known, and b) what is not known. Based on this, student groups develop a list of learning issues and divide among members within the group to research for the next class.
3. In subsequent classes, group members share information on what they have discovered about their assigned topic to help shed light on the problem, and to fill in the “what is known” and “what is not known”. In some PBL activities, the instructor adds new information along to the way.
4. The group writes the problem definition and identifies causes of the problem, and finally identifies solutions to the problem.
5. In closure, the instructor leads a discussion about the process and the conclusions reached.

Advantage

• Stimulates discovery learning and critical thinking
• Active learning process
• PBL is motivational for students (once accustomed to the method)

Disadvantage

• Learning to teach by PBL and preparation of learning materials is time intensive
• Students may be initially unhappy with strategy; they may feel they are doing all the work, and expect that role from the instructor
• Instructors often anxious about not covering “content”

Role playing, another type of simulation activity, is a dramatization of an event or situation – the situation usually represents a problem or a difference between two or more individuals, or a situation that is anxiety provoking. It differs from other simulation learning activities in that it is an unscripted scenario – the learners act out a problem in a completely spontaneous manner. This is a particularly useful strategy for practicing therapeutic communication skills and dealing with conflict.

Example of Role Playing

Dealing with an Angry Patient

Characters: Mr. John Markland, Mrs. Beverly Markland, and the Nurse.
Setting: Emergency Department Waiting Room

Situation:

Mr. Markland had been feeling very ill and experiencing abdominal pain when he called the “Ask a Nurse” hotline. The hotline nurse indicated his condition sounded serious, and advised Mr. Markland to immediately go to the emergency department for evaluation and treatment. Mr. and Mrs. Markland have now been waiting to be seen for over 6 hours. Mr. Markland continues to be in pain and is nauseated. He is angry, and does not understand why a man as sick as he is can’t be seen.

Mrs. Markland is also unhappy. In addition to being worried about her husband, she is concerned about her elderly mother left at home alone. She had no idea she would be away so long. She needs to know when her husband will be seen so she can decide if she should stay or go home.

The emergency room nurse is very busy with ill patients. The nurse is aware Mr. Markland is waiting (along with 8 other patients). The nurse does not have any beds available at this time in the emergency room. Additionally, the ambulance will soon be arriving with a 2 year-old-girl who was found floating face-down in the pool at her parents home.

While walking past the waiting room, the Markland’s stop the nurse and engage in conversation...

You will have 3 minutes to role play this situation.

Developing and Implementing a Role Playing Activity

To begin a RP session, students are divided into several small groups (groups of 5 is ideal) and presented with a problem.

1. Planning. The instructor must determine the goal of the activity and write a situation or context for the interaction to occur. Ideally the activity should be planned so that all students can participate in some way.
2. Implementation. To begin a simulation learning activity, the instructor assigns a role to each participating student, and then provides brief explanation of the situation so that all individuals generally know what they are to do. Give the students a designated amount of time to role play – the time will vary depending on the objective or task. Most role-playing activity sessions are short, lasting between three and five minutes.
3. Debriefing. The final phase of role playing involves debriefing. The instructor and students discuss the situation and various perspectives of the individual characters. Debriefing also allows time to provide feedback to students.

Advantage

• Stimulates critical thinking through problem solving and decision making during verbal exchanges
• Role playing requires active participation of the learners
• Allows immediate feedback to learners
• Allows students to gain insight, or understand the perspective of others
• Students usually consider this type of learning fun
• Can be applied in multiple settings

Disadvantage

• Development of appropriate role-playing scenario’s can be time intensive
• Some students are reluctant to participate, particularly if the role playing is done in front of a group of students
• May reinforce stereotypical behavior among students

Simulation activities involve controlled representations of actual clinical events. This strategy allows the learner to experience “real world” patient situations without risk. Learners are required to assess and interpret the situation, and make decisions based on information provided. Usually conducted in a laboratory setting, simulation learning allows students to practice a variety of skills including assessment, psychomotor skills, and decision making.

Example of Using a Simulation Activity (Video)

In order to view the example below, you will need Windows Media Player installed on your computer and speakers or headphones for your computer. See Information on downloading and using Windows Media Player.

Watch Video

Developing and Implementing a Simulation Learning Activity

1. Planning. The instructor must determine the goal of the simulation learning activity, write a scenario and script for the simulation, write instructions for the activity, and obtain necessary props or individuals (actors) for the activity. Ideally, the activity should be planned so that all students can participate in some way.
2. Implementation. To begin a simulation learning activity, the instructor must provide the student some brief, basic information about the situation, along with an objective. This may be a done in a number of ways – such as a verbal report or written information. The student is then asked to engage in the situation until the goal has been met.
3. Debriefing. The final phase of simulation learning involves debriefing. The instructor and student(s) discuss the situation offering feedback regarding what was done well and areas to think about.

Advantage

• Stimulates critical thinking through assessment, analysis, and decision making; thinking occurs in a non-linear fashion
• Allows students to practice and learn real situations without risk to patients/clients
• Students can repeat the experience as needed to develop skills and confidence

Disadvantage

• Development is time intensive – primarily due to the detail that is required of script writing
• Set up and implementation requires the cooperation of multiple individuals – this may include recruiting individuals to act as patients, individuals to assist with set up (especially if manikins with props are to be used), and recruiting additional faculty to facilitate the activity when multiple student groups are simultaneously participating in the activity
• Students need orientation/direction – instructions for the activity must be very clear