Supporting the Development of Critical Analysis through the Use of a Constructivist Learning Strategy
This paper will explore a particular aspect of the Graduate Diploma of Psychiatric Mental Health Nursing (the programme). I will analyse how the programme coordinator used the Instructional Design process through critical analysis in order to identify aspects of teaching and learning that could further enhance and best support students’ development of critical thinking in relation to psychiatric mental health nursing practice.
The programme is designed for new graduates entering the specialty area of psychiatric mental health nursing practice. This is a full-time course that is delivered collaboratively through a variety of clinical providers in the central North Island and upper South Island of New Zealand. The students come together for a total of five weeks’ theory. The remainder of the programme is delivered in a clinical setting. Students in the programme will have support through online components. This will enable students to open up discussion between peers and provide links to learning resources such as websites.
Utilising the first component of the ID process
The students are able to critically analyse aspects of mental health nursing through particular requirements inherent in academic assignments for this programme. In previous years, this was an issue as several students struggled with the critical analysis component. Critical analysis is a concept introduced in undergraduate nursing education, therefore the students should already be familiar with this concept. We need to identify what is going wrong and develop ways to support the students in completing their assignments. Instructional Design (ID) is a process for the design and development of instructional programmes (or components thereof) that support and stimulate the learner (Roberts, Conn, Lohr, Hunt & Duffy, 2003; Story, 1998).
I will analyse the programme as a whole and explore the philosophical underpinnings of the programme and the characteristics of students as adult learners.
My epistemological perspective is that of constructivism – ‘Constructivism is the notion that knowledge is individually and socially constructed, within the individual’s context’ (Merrill, 1991).
Merrill (1991) outlined the assumptions of constructivism as follows:
* Knowledge is constructed from experience.
* Learning is a personal interpretation of the world.
* Learning is an active process in which meaning is developed on the basis of experience.
* Conceptual growth comes from the negotiation of meaning, the sharing of multiple perspectives and the changing of our internal representations through collaborative learning.
* Learning should be situated in realistic settings.
* Testing should be integrated with the task and not a separate activity (cited in Mergel, 1998, p. 9).
Students of the programme are adults who have already learned the basic theory and practice of nursing. They have learned the scientific, legal and theoretical principles required to sit and pass the State Final Examination for registration. What is now required is the opportunity to apply this knowledge and theory in a practical setting and understand how the principles, laws and theories relate to working in specialist mental health nursing practice. These students need to have their prior knowledge acknowledged and extended to form new and deeper understandings of the subject area. In other words, applied knowledge.
Theoretical understandings in constructivist learning environments
Taking into account the philosophical positioning of constructivist epistemology and students as adult learners, I have decided to utilise the theoretical framework of Jonassen (1998) in this project. Jonassen discussed constructivist learning environments as opposed to objectivist (behaviouralist) learning environments. Within an objectivist learning environment knowledge is transmitted. Jonassen (1998) states, ‘since knowledge cannot be transmitted [based on constructivist conception], instruction should consist of experiences that facilitate knowledge construction’ (p. 271). This is achieved through the use of a model that places the problem, question, object or project at the centre of the learning environment, with a variety of support systems surrounding the experience. The problem drives the learning and is authentic or situationally based: that is, in the case of this programme, based in the practice of psychiatric mental health nursing.
As stated by Lave and Wenger (1991, cited in Herrington & Oliver, 2000) the situated learning environment resembles an apprenticeship where the student begins as the observer and, ‘as learning and involvement in the culture increase, the participant moves from the role of observer to the fully functioning agent’ (p. 24). This is further supported by Cole (1990, as cited in Herrington & Oliver, 2000) who suggests that:
Abstract knowledge taught in schools and universities is not retrievable in real-life, problem-solving contexts, because this approach ignores the interdependence of situation and cognition. When learning and context are separated, knowledge itself is seen as the final product of education rather than a tool to be used dynamically to solve problems (p. 23).
Merrill (2000) also identifies in his first principles of instruction that ‘instruction should occur in the context of solving a problem’ (Jonassen & Hernanzes-Serrano. 2002. p. 65).
Jonassen (1998) outlined the goals and preconditions for designing constructivist learning environments, as well as the values and methods. He states that the primary goal of this theory is to foster problem solving and conceptual development. This is intended for ill-defined or ill-structured domains (p. 216). Jonassen’s (2000) paper further discusses the dichotomies between general problem-solving strategies as solutions, and problem solving as a process. When facing a problem, the usual first thing to do is to identify solutions. However, with ill-defined and complex problems, the process of understanding the context and the complexities in order to develop solutions is more appropriate.
Jonassen (2000) goes on to discuss ‘domain or structural knowledge’ and that ‘how much one knows about a domain is important to understanding the problem and generating solutions’ (p. 69). So, in order to solve the problem, a high level of domain knowledge is required. However, Jonassen and Rohrer-Murphy (1999) note in relation to ‘Activity Theory’ that ‘as we act, we gain knowledge, which affects our actions, which changes our knowledge, and so on’ (p. 64-65). In this programme, lecturers and clinical experts work collaboratively with the students to guide and support them in problem solving in order to develop domain knowledge. Jonassen (1998) discusses the role of conversation and collaborative tools in this process, emphasising the need to ‘provide access to shared information and shared knowledge-building tools to help learners to collaboratively construct socially shared meaning’ (p. 228). Laurillarcl’s (2002) notion of a conversation framework involves the use of narrative and reflection in the learning environment rather than the transmission frameworks of university education. It aims to develop a reflective practitioner and lifelong learner.
Jonassen (1998) and Jonassen & Hernanzes-Serrano (2002) go on to talk about case-based reasoning. Students are presented with a problem or issue they do not understand. By sharing stories that highlight these issues and problems, principles and complex concepts that are applied in the practice setting will support students’ development. Jonassen (1998) also explores enhancing cognitive flexibility and provides a variety of viewpoints and multiple perspectives to convey the interrelatedness of ideas. This is supported by the current programme assessment, in that it requires the student to critically analyse a developing philosophy of mental health practice (evidence and research-based practice). The philosophy is made up of a variety of interrelated concepts. Students need to understand the parts in order to practice within the whole.
In summary, implementing a constructivist learning environment through the use of problem-solving and collaborative learning models would seem to be the best design and development strategy for the programme. The next section will look at translating the theoretical philosophy of a constructivist learning environment into the programme.
What content is required to best promote students’ critical analyses in relation to psychiatric mental health nursing? Firstly, there are the sociopolitical issues relating to practice, and in particular to the new practitioner entering this specialty. According to the research undertaken by Haggerty (2000), it is important to explore these issues early in the programme.
Secondly, the sociological imagination model frameworks introduced by Germov (1998) for supporting the critical analysis of a socio-political issue should be covered in the first two weeks of the programme. Some students may already be familiar with the model, particularly those who completed their Bachelor of Nursing at Whitireia Polytechnic; other polytechnics, however, may not have used this model.
Within the literature dealing with constructivist learning environments and strategies, what stands out as relevant to this project, and in particular to the students undertaking the programme, are three ways of working to support constructivist knowledge development: scaffolding, coaching and modelling. These have been incorporated into the learning strategies for the project (Jonassen, 1998; Brickell, Ferry & Harper 2002; Donald, Northover, Koppi & Mathews, 2002; Hedberg, 2002 and Love & Shrimpton, 2002.)
Scaffolding can be described as reinforcing and bringing forward already constructed knowledge and adding to it. This will be achieved in the following ways:
* We will introduce socio-political issues in psychiatric mental health nursing, with particular emphasis on the issues for new graduate nurses entering the specialty during the first week of theory in the classroom.
* The sociological imagination framework will be introduced to the students immediately after the socio-political issues session. The students will then be given a practice scenario, based on an entry, so that they can practice an issue in small groups by using the first three components of the sociological imagination framework – historical, cultural and structural. This scenario will provide enough information for the students to work with, while being ill-defined enough that students will develop critical thinking as part of the problem-solving process (Jonassen, 1998; Jonassen, 2000). The students will then report their findings back to the main group. Next, the group will identify the critical issues from the scenario for further exploration in class and this discussion will form the basis of a web quest which will be placed online in Blackboard (the online programme used by the Polytechnic) for the students to further explore in their own time.
* Students will be trained in distance learning and Blackboard in a supported environment. Two separate sessions will be run in the computer suite. Lecturers will demonstrate the library resources and Blackboard using the data show, while students each follow the process on individual computers.
* Blackboard will contain the web-quest and further activities for the students to carry out and report back on using the Blackboard discussion board. This will support students’ application of the sociological imagination framework in practice and the development of thinking around the first assignment.
* The Blackboard site will be further developed to allow students to submit their thinking about the socio-political issue they might like to explore as part of their assignment and receive feedback from their peers.
* If the issues identified are similar to each other, as moderator I will respond to the group by suggesting that smaller discussion groups be set up. Smaller groups will be voluntary, although students will be encouraged to participate. The smaller group discussions will provide the students with the opportunity to explore issues in a forum that may be less threatening than larger group discussions. Small group discussion supports collaborative learning, as well as developing students’ critical thinking in relation to the issue being explored for their major assignment.
This will be undertaken throughout the process. Both lecturers will support the face-to-face and discussion group activities.
* It is an expectation of the assignment that individual students will discuss the issue with the lecturer before starting the project. The lecturer will then coach the student to provide clarity about the issue and ensure it is not too big for the purposes of the assignment.
* As discussed earlier, lecturers will provide a supported entry into the online environment at the commencement of the programme.
* Lecturers will participate in discussion groups, responding to questions asked and suggesting possible ways forward or raising questions to be further explored by the students.
* Lecturers will provide computer suite access during the first two tutorials offered monthly. Students will have access to the Blackboard environment and will continue supported discussion group activity.
This operates throughout, and is an integral part of the programme.
* Lecturers will model good communication skills, identifying the personal resources of students and collaborative teamwork. This models the relationships and attitudes that support good clinical practice in mental health nursing.
* Lecturers will also model the characteristics of critical thinking in relation to problem solving. Through interactions, face-to-face and online, the lecturer will not offer solutions, but will guide the student toward thinking broadly about the issues and topics being explored. The lecturers will then pose questions to promote the students’ critical thinking. This supported, self-directed learning in turn promotes life-long learning.
Students of the Graduate Diploma of Psychiatric Mental Health Nursing are expected to be able to critically explore evidence in relation to their practice. However, critical analysis for evidence-based practice is a skill that needs to be developed and does not come naturally. The purpose of this paper has been to look at how this component of the programme could be delivered to better support students develop critical analysis for evidence-based practice.
As part of the instructional design process, I have explored this component of the programme within a constructivist philosophy. I have identified the content and learning strategies which best support student achievement. All that is left to do now is to implement this project and evaluate the results on its completion. 1 hope the students of 2004 find The Graduate Diploma of Psychiatric Mental Health Nursing exciting, motivating and supportive of their individual development and confidence in using evidence to critically support practice.
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