NURS1427 Learning And Teaching In Practice

Adult nursing

Urethral catheterization is used for relieving urinary retention that requires proper indications for catheter use (NICE 2014). Nurses and other healthcare professionals must possess competency skills to carry out the procedure with efficiency. At the same time, the nursing students need to be supervised who are striving to achieve the competency skills for female catheterization as outlined by Mangnall 2014. Many learning styles and theories have been discovered that suggest every individual has preferred learning style for the effective learning. The learning style that was identified for the female catheterization learning in this scenario is visual and aural presentations (V&A), reflector type. Visual and aural is an effective tool that is helpful for the nursing students to observe the interactions and develop skills for the catheterization process (Rohrer and Pashler 2012). After this process, the mentors demonstrated the process to facilitate the students to learn the professional techniques and skills. The learning style of V&A is associated with cognitive learning theory (CLT) that focuses on behaviourism enhanced by social interaction will be discussed in the assignment. The learning environment involved was a group based classroom and group demonstration of female catheterization process (Ayres and Paas 2012).  For the facilitation of learning experience, lesson plan was developed that included the aims and objectives of learning session, time scale and required equipments. It has to be mentioned that for this learning program the two learning theories that had been used are the social learning theory and the cognitive learning theory. The learning style that was incorporated in the learning event had been the VAK learning style and thelearning event was based on the questionnaire.

The process of learning can be defined as the step by step process of acquiring the knowledge and skills by the maenad of a collective process of studying, experiencing and being taught. This knowledge can stretch onto values, beliefs, principles, attitudes, and preferences. Some of the learning activities can be immediate facilitated by a single event, and on the other hand, some of the learning activities can require the assistance of repeated or multiple events and results into accumulating varied knowledge or skills. For this study, the leraning acruvity had been based on the questionnaire activity and the learner involved had been a reflector type learner.

The teaching method that mentors used was aural and visual with elements of practical demonstration. The second proposed learning theory is the social learning theory (SLT) that is expected for the learned in terms of skills and behaviours that are acquired by the learner. Bandura’s SLT posits people to learn from others via observation, imitation and modelling. The cognitive and behaviourist learning theories encompasses memory, attention and motivation. This method is useful for making people learn about new things and development of learning styles among the individuals. This method was used for making nurses learn the female catheterization method as it is based on observational learning (Hanna, Crittenden and Crittenden 2013).

There are four stages involved in SLT that helped nursing students to understand the catheterization process effectively through observing behaviours involving attention, retention, reproduction and motivation. In the first step, the students paid attention to what they are willing to learn. The mentor demonstrated the process of catheterization where a female catheter is inserted safely through the labia minora into the urinary meatus. In this step, the students are away from distraction and they are interested towards the model that is used for teaching catheterization process. The more the students pay attention to the process, they can learn better. In the second step, there should be retention of newly learned behaviour that is necessary for the nursing practice. Without retention, it is not possible for the students to retain the relevant information that they have learned during the demonstration. They need to go back to the observation of the model if they are unable to store information about the new behaviour. The third step is reproduction where the students need to demonstrate the catheterization process so that they can pay attention and retain the relevant information. In this step, the process of catheterization needs to be practiced by the nurses repeatedly so that they remember and improve the process. The last step is the motivation where the new nurses need to feel motivated to repeat the process or new behaviour so that they keep performing it. The use of punishment and reinforcement comes into play and one need to be rewarded as they demonstrate behaviour properly and punishment on inappropriate display of the behaviour (Davis et al. 2015).

The main disadvantage of SLT is the possible dearth of literature in context to differential reinforcement driven by the theory of causal mechanism. The reinforcement used in this process is the result of experimental research limits the learning ability of students. When the mentors do not demonstrate the new behaviour or action (female catheterization) properly, the nurses may learn the process differently that may hamper patient safety during female catheterization and causal mechanism. In such cases, there are instances of unwanted behaviour and over imitation by the students. To avoid such situations, mentors should demonstrate effective mentoring so that individuals learn and develop the new acquired behaviour (Rodela 2013).

The second learning theory that had been used in this context had been the cognitive learning theory. According to this antagonistic learning theory, the process of learning can be easily analysed by the underlying mental processes that has been used in the scenario. As per this particular theory, the process of learning and acquiring different skills and knowledge can be facilitated by the effective cognitive processes. Along with that, this theory also postulates that with optimized cognitive processes associated, the memory can be stored much more effectively and for a longer period in the learner’s mind. And similarly, the impact of ineffective cognitive processes will result onto ineffective learning process with different learning difficulties.

With respect to this discussion, this particular learning theory describes learning process to be an internal purposeful activity that involves thinking, perception, information processing and memory. As per the explanation by Piaget, the cognitive development can be distinguished into 4 different steps, sensorimotor, preoperational, concrete operational, and formal operational period. Hence it can be concluded that children learn by the process of assimilating new data and then accordingly modify their understanding. Therefore, applying the cognitive learning process it can be mentioned that a similar cognitive learning procedure is reflected among te adults as well.

The teaching method used by mentor was Bobo Doll experiment, learning through observation, copying and imitation. Bobo doll experiment is an effective process that is based on observational learning in social cognitive theory by Bandura in the year of 1961 and 1963. In this experiment, the beahvior of a child after watching an adult model aggressively assaulting the bobo doll was critically examined and evaluated. It has to be understood that in this experiment, this automatically gets up every time it has been knocked down to a standing position. The most important fact associated with the learning activity is the analysis and understanding of the child after seeing the model being rewarded, punished or receiving no consequences after beating up the doll. This experiment is an excellent extension of the social learning theory by Bandoora, which states that learning process can be facilitated by watching others doing a particular activity. According to this theory there are 4 processes of learning associated with 4 particular activities Attention, Retention, Reproduction and Motivation. The experiment is used to investigate social behaviour followed by observation and imitation.  Cognitive learning theory is an integral purposeful activity that involves thinking, perception, processing of information and memory. The nursing students adopt the task of female catheterization process in a meaningful and logical manner so that they can use it in their own nursing experiences and knowledge. This learning theory can be beneficial for the mentors in explaining the catheterization process and asks the adult nurses on how it works out together in regards to the problems. The identification of apocopate nursing care that is related to physiology and patients who have been nurses with this condition. The main advantage of this experiment is that it can be replicated. The students can replicate the standardized procedure of catheterization and instructions used in the process, although there might be slight changes as there is a gap between demonstration and actual clinical practice. The behaviour of the mentor greatly affects the behaviour of the observer as the nurses not only watched what mentor did, but also watched what happened when they demonstrate the process (Reigeluth 2013). It has to be mentioned that the benefit of the VAK questionnaire is optimal and if any other learning framework was given or if the mentor had been a poor role model then it could not have been followed and hence the main outcome of the experiment would have been defeated.

In the teaching session, there were no distractions so that students are focused on the task. The mentors were intended to provide a learning environment that is suitable for the students offering comfort and enhanced learning. Considering this, the mentors gave VAK questionnaire to the learners to know about the preferred teaching style that can offer optimal learning. There are 16 multiple-choice questionnaires where students have to choose one option out of the four to answer the questions (Prithishkumar and Michael 2014). Every answer is related to different learning style and while developing the teaching plan for the learners, mentors need to consider the VARK aspects identified by the questionnaire. After this, it was identified that aural and visual is the most preferred learning style and incorporated in the teaching session. In this session, the mentor adopted the VARK style of teaching that addresses the preferred learning styles as per the learners. SLT uses repetition and observation identification of competent skills and behaviours that is related to change in a person’s behaviour. CLT also encourages learning among the learners when they are engaged in practical experiments. It involves memorization that resulted in purposeful and intended action (Kharb et al. 2013). Only one questionnaire had been given to save the time and in order to make the study more precise and targeted.

The teaching method through combination of aural and visual styles encouraged learners in observing, practicing those skills and use of pamphlets that enhances and maximizes their learning experience. This session allowed time for discussion and reflection regarding catheterization with an aim of making learners understands the task. Visual and kinaesthetic teaching styles were most appropriate teaching method for catheterization that allows visualization, observation, intimidation and optimal learning experiences in the classroom environment (Prithishkumar and Michael 2014).

The learning from observation and imitation is deduced from social learning approach that acknowledges the role-play in deciding whether behaviour is intimidated or not. It provides a more comprehensive way of human learning where it uses meditational processes. The cognitive control of individuals over behaviour is also involved in this process where one is careful while reproducing behaviours. Observational a learning that was used for the female catheterization is a result of observing the mentor and later performed it. Behaviour avoidance was also involved in the learning process where they felt that negative consequences should not be intimidated (Heyes 2012).

The VARK questionnaire identified that the learner in this session is reflector learner. In this type of learning, the learners observe and think about the learning incident that happened. This method avoids leaping in and they prefer to observe where they stand back and view the demonstration from various perspectives. There is collection of data and take time to learn the new behaviour and make an appropriate conclusion. This method comprises of paired discussions, personality questionnaires, self-analysis questionnaire, observing activities, coaching, feedback and interviews. For this session, observing the activity of catheterization, taking feedback from others and paired personality questionnaire was used. The reflector stands back to watch the experiences by observing the mentors performing the process of female catheterization. They observe the demonstration from different perspectives like collection of data and learning from others (Merriam, Caffarella and Baumgartner 2012).

A reflector prefers to think about an activity thoroughly before they reach a conclusion. They critically analyse the situation by thoroughly collecting data from the session or experience, however this might delay or postpone the definite conclusions as much as possible. This philosophy makes the learners cautious and thoughtful making them considers the event from every possible directions and implications before they make a move. The reflectors prefer to observe people during demonstrations and discussions as they enjoy observing other people’s action. They listen to others carefully and take a drift of the discussion before they reach conclusion or make their stand. A slightly distant and low profile with unruffled air is observed among the reflectors that give a wide picture of all past and present observations of others and own. The literature considers reflectors as distance learners who need time for absorbing information (Moon 2013). They may be bogged down with the learning theories, spend time for surfing more information and start learning themselves and this is the way their learning is affected.

The second preferred learning style is SLT that is focused on learning in a social context where individuals learn from each other through learning, modelling and imitation. In this session, the nurses observed the behaviour of the mentor and outcome of their behaviours. From the behaviourist’s perspective, learning should be a permanent change in one’s behaviour whereas SL theorists suggest that individuals can learn from observation; however, it may not be visible in their performance. SLT is also a part of cognitive learning theory where human learning is interpreted (Cherry 2012). Learners are believed to be capable of accomplishing their new tasks by developing a sense of self-efficacy in them. Although, SLT defines the imitative learning, however, it does not provide the way an individual is motivated in performing the expected behaviour in absence of the model. This method also guides us in understanding the fact that why people behave differently in different situations as some observed learning is being rewarded in some situations and therefore, learn behaviours that are inappropriate in particular contexts. However, this method cannot be tested experimentally as the individuals may imitate aggressive and inappropriate behaviour (Brauer and Tittle 2012). Therefore, it is important to stop execution of bobo doll experiment, as evaluation of SLT is difficult and consequently it may be difficult to establish the credibility of the experiment.

The visual and aural learning style is the first learning style that was preferred for the session. Visual and aural learning styles are a part of observational learning theory under the SLT. In this process, visual learners are using the handouts, diagrams and demonstrations in well and stimulating environment. These materials are helpful for the learners in drawing their attention and no distractions during the demonstration (Riding and Rayner 2013). The four SLT stages are associated with kinaesthetic, visual and aural learning styles that comprises of attention, retention, motor reproduction and motivation that indicates similarities between the two methods. The continuous visual learning process without the participation can make learner switch off that indicates good coupling between the two styles of aural (A) and visual (V) learning styles. Kinaesthetic (K) learning style can also be used along with aural and visual styles as it helps observer to acquire a new skill and use them in their learning experiences. After observational learning, the nurses need to carry out the demonstrated physical activities instead of watching demonstrations or listening (Schunk and Usher 2012). When K is used in combination with A or V learning style, it produces multi-sensory learning.

A new registrant need to develop essential understanding of one’s own learning style for gaining confidence and potential to disseminate the knowledge. Continuous Professional Development (CPD) is the best way to disseminate experimental knowledge of female catheterization to the new nurses enabling them to learn the new behaviour within their scope of nursing practice. This facilitates in providing an environment to the nursing students where they understand the process and be accountable for their actions during retention, reproduction and motivation process (McCusker 2013). The V&A learning style of students need to be investigated and improved for both learning and teaching skills in the process of catheterization.

Nursing and Midwifery Council (NMC) support nurses through lifelong learning. Nurses are lie-long learners who acquire new knowledge and skills and try to maintain it through CPD at their workplace and clinical practice. There are separate standards in NMC where for the completion of CPD, one has to complete number of hours in practice for renewing their registration as nurses (Ricketts, Merriman and Stayt 2012). The Royal College of Nursing (RCN) guide mentors and nurses in translating theory into clinical practice, from classroom to reality. Mentorship is critical for providing optimal learning experiences to nurses in clinical settings ensuring that their competencies and skills are appropriate for the clinical setting. A registered nurse may act as a mentor who has the responsibility to recruit qualified nursing staffs who can transfer the gathered information on female catheterization into clinical practice that supports their life-long learning (Addison et al. 2015).

According to NMC, all new nurses to mentor and teacher preparation programs should be able to meet the requirements outlined in the standards for supporting learning and assessment in their clinical practice. It also sets out developmental framework that supports learning facilitating in personal and professional development of the nurses. The preceptorship program is also conducted for the nurses who qualify as registered nurse as transition from nursing student to an accountable healthcare professional is a daunting prospect. They possess knowledge and competency; however, they need guidance and support from experienced healthcare professionals like RNs in finding their feet in the clinical practice (Harrison-White and Simons 2013).

It is obvious that no particular learning or teaching style is effective as these styles vary from one individual to another. The mentors need to be connected to the preferred learning style of learners, their needs in order to provide the best and suitable learning experience to them. For understanding the learning style of the learners in female catheterization, the mentors need to perform Honey and Mumford’s questionnaire or VAK questionnaire in order to provide the best learning experiences for them. The lesson plan that focuses on the preferred learning style of V and A along with K helps nursing students with their learning needs. The learning theory for the nurses is SLT; however, combination of different teaching theories and styles can facilitate optimal and life-long learning among them. Many programs like preceptorship, CPD and teaching programme helps nurses in exploring and enhancing their learning experiences. Most importantly, the preferred learning style of learners needs to be taken into consideration for every type of learning experiences.

References

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