CURRICUUJM DESIGN IN NURSING
Item
- Title
-
CURRICUUJM
DESIGN
IN
NURSING - extracted text
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GILLTREMLETT
CPHE
CURRICUUJM
DESIGN
IN
NURSING
A Practical Guide
For Course Planners
Jean Heath
1
J
CPHE
A PRACTICAL GUIDE FOR COURSE PLANNERS
By
Jean Heath
BA SRN SCM Cert Ed
Produced and Published by:-
NHS Learning Resources Unit
Sheffield City Polytechnic
55 Broomgrove Road
Sheffield S10 2NA
Tel.
1982
0742 661862
FOREWORD
This book is offered as an aid to those who
are faced with the task of having to plan courses
without the necessary background training in
curriculum design.
A simple yet effective structure is presented
which takes into account current thinking in
both nursing and education.
It offers a framework for making decisions in
a logical sequence of steps. This framework
can be effective whether the planning is for
statutory or in-service courses, for a seminar,
a workshop or a formal lecture.
The relevance and quality of the design is
measured by the extent to which it facilitates
learning in those we plan the courses for.
CONTENTS
Page
Glossary of Terms
1
Introduction
7
Choosing a Model
13
Assessing the Task
18
Identifying Aims
24
The Conceptual Framework
26
Curriculum Objectives
35
Learning Experiences
40
Aids
49
Evaluation
52
Bibliography
64
Appendix A
70
B
79
Appendix
AIMS
A statement of intent so that students
and staff are fully aware of the
intentions of the course planners.
A clear aim is an essential first step
in the development of a course.
ANALYSIS
’’The breakdown of a communication into
its constituent elements or parts such
that the relative hierarchy of ideas
is made clear, and/or relations
between the ideas expressed are made
explicit. Such analyses are intended
to clarify the communication ...”
(Mager 1975)
CURRICULUM
”A programme of activities designed
so that learners will attain, as far
as possible, certain educational ends
and objectives . . .”
(Hirst 1970)
It is the total of all teachings
together with strategies and techniques.
It has four basic elements:
Objectives
Methods
Content
Evaluation
”An attempt to communicate the
essential principles and features of
an educational proposal in such a form
that it is open to critical scrutiny
and capable of effective translation
into practice”.
(Stenhouse 1974)
1
OBJECTIVES
- EdacatT.onaZ
ObjzcttveA
’’Explicit formulations of the
ways in which students are
expected to be changed by the
educative process, i.e. the
ways they will be changed in
their thinking, their feelings
and in their actions".
(Bloom 1972)
- A^ccttve
VomaZn
Obje,cJ~Tv(LA
Objectives relating to human
behavioural characteristics
concerned with valued,
attitudes and emotional sets
or biases.
- CogrbcTtve.
VomaTn
Objectives
Those relating to thought
processes.
- PAtfcJwmotoft VomaZn
Objectives
Those relating to physical
actions.
- Taxonomy of^
ObjzctiveA
Behaviours classified on a
continuum or in a hierachical
order e.g. in Bloom’s Taxonomy
of affective domain objectives -
awareness of . . . comes
before - attending to . .
which comes before valuing.
EXPERIENTIAL
LEARNING
Meaningful learning which
involves the learner gaining
insight and understanding by
some form of active
participation.
2
SYSTEMATIC
APPROACH
- in the context of this book:-
a logical sequence of steps
which involves a careful
analysis of the setting,
the constraints, the learning
needs, the organisation of
learning and evaluation.
This is sometimes referred
to as the Objectives model
or the Tyler model.
FURTHER READING
EATON J
(1975)
An ABC of the Curriculum
Pub. Oliver and Boyd,
Longman
3
SUGGESTIONS FOR USING THIS BOOK
At the end of each section I make suggestions
for your actiono
If you work through these
’suggested actions’ you will have experienced
the planning process as advocated in this
book.
On the other hand you may wish to read through
the book first and then return to the activity
sections.
They are summarised on the next page.
Suggestions for further reading are incorporated
throughout the book but these are kept to a
basic minimum.
This book has been planned for those who are
concerned primarily with the planning of
courses for nurses.
The student of Curriculum
Development and Design will need a much wider
base for her study.
4
SUGGESTED ACTION SUMMARY
You may like to use these as possible objectives
for you to achieve.
1.
Reflect on your position in relation to
the different views of education presented
here, or you may like to consider how you
view teaching. The questionnaires on pages
10 & 11 may help you clarify some aspects
of this.
2.
Consider the constraints on the planning
and decision making for your course.
3.
Make the first draft of the aims of your
course.
4.
Draw your conceptual maps.
Organise related concepts and themes into
units or modules.
Consider the time you have available and
try to allocate the material appropriately.
Consult with subject specialists for
comments on the course framework.
5.
Consider the course aims you have written
and the framework of the main concepts.
Take each module or unit of learning in
turn and write the first draft of
objectives for the course.
Ask for constructive criticism from
colleagues.
6.
Consider each objective you have written.
List the learning experiences you fedl will
best help the learners achieve them, bearing
in mind that practising a skill will lead
to proficiency.
5
Can you suggest other factors which will
encourage skill acquisition?
7.
Consider what assessment techniques you will
use to help ascertain if learning
objectives have been achieved.
Consider what strategies you will employ
to evaluate design issues and implemen
tation of the course you have planned.
6
When planning any course, decisions have to be
made about what is to be learned, why it should
be learned, when and how it is to be learned and
how learning is to be assessed. A systematic
approach to curriculum design offers a useful
framework for decision making. This involves
defining aims and objectives, a consideration of
teaching and learning strategies and an integrated
plan for evaluation. This approach can provide
the course planner with an efficient tool to
produce a course outline, but the resulting course
may not provide nurses with the right skills to do
their jobs. It all depends on the kinds of
decisions which are made. These should be firmly
based on a careful analysis of what we are
attempting to do and what kind of person, with
what kinds of knowledge and skills, we, as planners,
would like to see at the end of the education and
training programme.
There is a need to get away from too narrow a view
of the curriculum with its emphasis on content and
time-tabling, and see it rather as a dynamic concept,
reflecting our values and attitudes, embracing
students’ needs, and taking into account teaching
styles and learning climates. The resulting plan
can be an integrated, harmonious whole.
7
CONTRASTING VIEWS OF EVUCATION
In general education different approaches can
be identified which reflect, to some, extent,
the changing social climates. In a teaching
situation we might find a mix or adaptation of
any of the following:-
The mental cLoieTpLcne approach education should concern itself with
mental functioning or habits of
thinking.
The cTM^teaZ approach assumes the learners are passive
instruments to be manipulated, The
teacher may assume a role of
benevolent autocrat, attempting to
realise her objectives by motivating,
controlling and modifying learner
behaviour by some variant of the
talk and chalk method. It is
essentially task-centred and teacher controlled.
The ^omcmtcc o^t humanLstTc vTew
is essentially learner-centred and
related to discovery learning.
A ’mode/in' approach
assumes that students are natural
decision makers and problem solvers.
The emphasis is on the process i.e.
enquiry-centred, experience
orientated rather than content or
method. Instead of thinking of factors
separately there is an emphasis on
integration and synthesis.
8
FURTHER READING
Curriculum Design
GALBY M et al
editors (1975)
Ideology and the Curriculum
by Fred Ingles pp 36-47
OU publication
SuzjgeA-ted AcZcon
1
Reflect on your position in relation to the
differenct views of education presented here,
or you may like to consider how you view
teaching.
The questionnaires on the next
two pages may help you clarify some aspects
of this.
9
For example, you may consider yourself to be a
very democratic sort of teacher. Try to identify
your position in relation to the points of view
presented below as honestly as possible.
I
1
1
Policies are a matter
for group decision
encouraged by the
instructor
All policy should be
determined by the
ins tructor
I
1
1
I
Learning steps are
presented one at a
time
I
1
1
I
1
I
Overall course
perspectives sketched
out at beginning
of programme
1
Instructor dictates
work to be done
I
J
1
Division of work
decided by group
1
1
1
1
Instructor remains
aloof from active
group participation
Instructor a regular
member of the group,
facilitating not
directing
I
I
1
Instructor "personal”
or subjective in his
praise or criticism
1
J
Instructor objective
or factual in his
praise or criticism
10
You might also like to consider the following
statements and decide whether the behaviour
suggested is:
a.
desirable
and
b. feasible
a.
b.
The students (course members) must be able
to:
set their own personal goals related
to their work within the constraints
of nursing care
develop their own approaches to the
achievement of these goals
seek criticism from teachers and
colleagues
collect relevant data and utilise
it for solution to problems
audit their own performance or that
of a colleague using established
criteria
learn and think independently and
learn from experience
acquire independently information
that is usually transmitted by
traditional lecture courses
A function of a teaching institution
should be to help students find
solution to nursing problems.
Adapted from a discussion paper by J J Gilbert,
WHO, Geneva, on Basic Issues in Curriculum Design
and Implementation (30 November 1977).
11
I would not suggest that there is a right or
wrong position, but rather that, as teachers,we
should try to discover where we stand. When
planning a course the value systems of the
planners will be reflected in varying degrees.
(Ve AhouZd /iccognZde .that
ousv
and vatuM
sie.ga'idtng na^itng, tracking
and tzcvincng , uic££
tn^tuznce. the dectston^ ive
maize about the coti/izci Me
ptan, maM. tn^tuenee the
May Me teach oft the
tea/vntng expentenccA Me
choose fiott oust Atadent6o
12
a
There has not been a great deal written about
curriculum planning models for nurse education
in this country. Much has been written by the
American nurse educators and, as American
students are college based, we often dismiss
their ideas as not being applicable in Britain.
However, I would suggest that we take an
eclectic approach by selecting and adapting to
fit our own particular needs.
The needA bcued model
(Sta/tpole
Wa£tz, 19 78)
The philosophy behind this approach is that if
students can identify their needs in a learning
situation, the learning will be more meaningful
because it is directly related to the experi
ences and current needs of students. For the
trainer this necessitates a careful analysis of
the situation the student is being trained for
and an identification of all the knowledge,
skills and attitudes which are likely to be
required of the trainee in order to equip her/
him to perform effectively. It necessitates
regular appraisal of the individual student’s
needs in relation to his/her choice of learning
objectives. This model has many attractions for
those who wish to encourage their students to be
self-directed. It lends itself particularly to
post-basic courses but I feel it is rather
difficult to implement in a pure form with
large groups of students taking a National
Certificate. However, this approach can be
integrated into seminar and tutorial sessions
and could be most useful in the practical
situation.
13
The.
mcdeJL
This approach stresses the importance of the
learning
rather than the collecting of
information i.e. the process of learning rather
than the products of learning. It involves asking
questions of the students, setting them problems,
and encouraging them to find the answers. The
attractions of this approach are that students,
hopefully, are equipped with the skills for up
dating and renewing their information, they do
not view teacher figures as being the main source
of knowledge and they tend to be self-directed and
motivated, taking responsibility for their own
learning.
The Nursing Process, with its systematic problem
solving approach to Nursing Care, might easily
adapt to this curricular model. For example,
learning could be arranged around some of the
following questions.
J.
On A^^e^Tng
- What information do I need to collect?
- How much and why?
- How best can I collect the information
needed?
- Where do I get information from?
- How do I record this information?
2.
On PT.annT.ng
- Do I have the necessary skill to plan
effectively?
- How shall I know which problems are
priorities?
14
3.
On Imptementcng tiio, Ptctn
Do I have the necessary skills and
knowledge to carry out nursing plans?
4.
On EvaZaation
How shall I know if my actions are
effective?
By what criteria shall I assess my
own behaviour and that of my
colleagues?
This might be a promising model but I think at this
present time it would be very time consuming to
build the curriculum totally around it. I would
prefer to see this approach being used to draw
together, in a meaningful way, different aspects
of knowledge and experience the students may
have, thus enabling the students to integrate
theoretical knowledge gained in the classroom
with practical experience gained in the ward,
and to focus their attention on the care of the
individual rather than diagnosis and treatment.
In a similar way to the example suggested for the
Nursing Process, it would be feasible to model a
curriculum around the "needs of man" and the
components of basic nursing care as described by
Virginia Henderson (1969) for example
Helping patient with - respiration
- eating and drinking
- elimination
- maintenance of
posture etc.
- rest and sleep
(Taken from page 19 ’Basic Principles of Nursing
Care’ by Virginia Henderson, revised 1969,
published by the International Congress of
Nurses.)
15
The. 6(/6tenia^cc model
This model has been in vogue for some years, In
its earliest form it was written about in 1949
by Ralph Tyler, often referred to as the Tyler
Model. It became popular in the late 60s when
programmed learning was in vogue, industrial
training schemes have adopted this model. It is
used widely in the training schemes of the
services i.e. Army and Navy. It has been written
about in the nursing press in this country since
1970 by Sheila Marson, who applies this model to
the design and development of self-instructional
teaching materials for nurses.
This model asks us to consider the answers to the
following questions:What educational goals should we seek
to attain?
What educational experiences can we provide
that are likely to attain these goals?
How shall we organise the learning
experiences?
How shall we determine whether these
goals are being'attained?
If we are concerned with efficiency and are able
to say what we would have our students know and do
then this model is worth considering. It need not
constrain or confine the learner in the pursuit
of identified objectives but will enable the
course planner to decide on minimal core issues
i.e. those aspects which are essential.
Curriculum building is seen as an orderly process
of decision making, an assessment of needs, a
detailed plan of action and evaluation of the
process and the final outcomes. There are many
ways of presenting the systematic framework
16
(see figure 1). I see it as an integrated cycle,
each part of the decision making process affect
ing and being affected by the other parts. This
model is constantly being reviewed and updated in
the light of the changing context and can accom
modate most views of nursing education. It is
applicable to any training situation at whatever
level. It can be used equally well for the plan
ning of one lesson, or for a complex 4-year
programme. It is adaptable to different teaching:
styles and to the pendulum swing of "educational
fashion".
THE CONTEXT
Course aims
Evaluation
The Nurse
Theory
Practice
The Teacher
Course
Structure
Implementation
Course
Objectives
Figure
1
A Systematic Model
17
Education, in general, focuses on what is to be
learned, and who is learning. In nursing the
focus widens to embrace the patient, the environ
ment and the caring team. Many would say that the
whole purpose of a nursing course was to produce
a safe practitioner. We need to ask then what do we mean by a "safe practioner"?
In some cases it might mean - a person who can
carry out simple nursing procedures without
supervision.
Other examples might suggest:
-
a person who can make nursing decisions,
plan nursing action, coordinate care,
solve management problems, initiate
research or decide on future nursing
policies.
At one end of the continuum then we have simple
psychomotor skills and at the other the skills
involved in professional and personal development.
As a course planner it is important to spend some
time considering this kind of issue and ask the
question -
-
What kind of end pAoduCxt have we in mind?
Are we maintaining the status quo or are
we taking into consideration current
changes in the social climate?
Anothor major influence on nursing and nurse
education today is "The Nursing Process"*. This
is a systematic, problem-solving approach to
individualised nursing care. The focus is on the
*
See bibliography for further reading.
18
patient and his needs and each plan of care is
carried through and evaluated. The main nursing
goal is to work towards that which is normal for
each patient. The knowledge needed by the nurse
is centred on the patient and his or her needs.
Skills needed include the ability to;observe the patient in his environment
assess and state his needs
instigate action if required
seek assistance if required
interpret and carry out prescriptions
and report on the results
communicate with patients, relatives
and colleagues
organise and teach other nurses in the
health team
--
assess critically and evaluate her own
work and that of her colleagues1.
J This is the profile of professional respon| sibility drawn up in connection with the
J nursing directives for the EEC.
|
|
|
When choosing and organising curriculum content,
a study of the needs of the normal healthy
person should be considered before moving on to
the breakdown of health.
The lA)ay we teach can influence the student, too
much giving of information can encourage our
learners to be dependent. If we would wish to
encourage accountable problem solvers then we
need to bear this in mind when considering
learning experiences. If we are always the ones
who evaluate and assess, how will the learners
gain skills in evaluating the care they give and
19
assess their own performance and that of others?
CONSTRAINTS ON PLANNERS
Before setting out the educational aims of your
course it might be useful to identify some of the
constraints affecting your particular situation
(see Figure 2). I have listed some which might
affect any curriculum planner. These have been
divided into - external factors i.e. those which
affect the general organisation of the course, and
over which you may have little or no control, and
internal factors, those which relate to the
immediate teaching/learning transaction.
The
Organisation
Examining
Bodies
Resources
Subject
Curriculum
Decision
Making
Theory/*
Practice
Service
Needs
Science and
Educational
Research
Social
Trends
Technology
Figure
2
Factors affecting decision making
20
expectation-*
the. o^ga^c6a./X.on - if you
have been appointed to put on a series of
courses it would be useful to agree aims with
those you are responsible to at an early
stage of planning.
- time available,
day or block release, in-service or own time.
avat£ab£e - course rooms, money
for resources, books, hire of AV media,
AV equipment, specialist lecturers, practical
experience .
accoantabiLuty - is it necessary to produce
hard facts as to the success of your course?
Will your educational aims and objectives
and your evaluation results be publicly
available? e.g. State examination,
JBCNS certificate.
Aubje.Q.t AfiZoZaLifitb - course planners are
not necessarily subject specialists. Will
you have adequate support and backing at the
subject level?
subject matteA - the nature of the subject
may affect the design of the course.
i.e. Intensive Care Nursing, psychosexual counselling, group interaction or
coronary care.
/te*ea^c/i /tepo/tt* - is the course you are
planning a direct result of a recent piece
of research? Its findings will have a direct
influence on your course aims.
-ioeiot ttend* e.g. - the likely increase
in the number of aged in the community in
21
the year 2000
The move from an autocratic to a democratic
social climate may influence teaching plans
and decisions.
new Aate.ntt£tc and te.ahnotogtc.at advances
COU/LdC te.uet6 - if the course is part of an
ongoing training scheme at different levels
e.g. introductory, intermediate, final, then
consultation will be necessary with other
course planners to make sure you are not
providing similar experiences for your course
participants .
InXe/tnnZ Factor
th.0,
- it is necessary to identify
their learning needs, taking into account
their present knowledge and experience.
the. teuch(M - their teaching styles and
educational values. Teachers may be excellent
in the lecturing situation, their blackboard
summaries a joy to behold, but they may feel
very uncomfortable with the open ended
discussion approach. It is as well to know
your staff and their particular strengths
before planning learning experiences.
JLQjlA.YiiviQ thtOtLCeA - educational experiences
should be planned, taking into account the
theories connected with how people learn.
the. ^eAx)tc.e. ne.e.d6 - if your course is connec
ted with a speciality, then it is vital to
have the fullest co-operation of the specialist
staff. Service staff should, if possible,
help draw up the educational goals for the
course and be committed to enabling learning
22
in the practical setting.
FURTHER READING
ROBERTS K (1981)
’Futurizing’ the Curriculum nursing education in the year
2000.
Australian Nurses1 Journal
Vol 11 No 3 Sept 1981
pp 49-52
Saggerted Aetton
2
Consider the constraints on the planning and
decision making for your course.
23
"An aim can broadly be defined as a general state
ment, which attempts to give both shape and
direction to a set of more detailed intentions for
the future" I K Davies (1976). It is an ideal,
an aspiration, a direction in which to go, but it
must be constantly re-defined in the light of
experience and subsequent action.
K
ofa cum ia a. my
making
pubtcc you/c educational Intent.
You may be involved in planning programmes for
staff development, so before starting to write
your aims it is advisable to make some rough notes
on why you think a course or training programme is
needed. It is also useful to get the opinions of
colleagues, service staff and potential course
members. In this way it is possible to suggest
the distinctive ’need’ for the course you are about
to plan. Some thought should be given to the
prospective course members. What knowledge,
abilities and attitudes do you think they should
have after your course? It would also be useful
to provide the potential students with reasons
for their participation in this course, whether
for better career prospects, improved knowledge
and efficiency, to gain an extra certificate or,
opportunities for further study.
It is important to write down as many answers as
possible to the question: "What do I want this
course to achieve"? These answers are the first
rough statements of the course aims. They can
later be edited, inconsistencies removed, and
repetitions eliminated.
u
The final aims should be written in such a way
that they suggest directions for teaching and
learning.
Ex.amp£e, ofa a
alm
From ’’Care of the Elderly in Hospital and
Community”*
The philosphy of the approach in this
course is to encourage staff not to
consider ill health as synonymous with
the ageing process.
Suggested Acllon
3
Make the first draft of the aims of you
course.
*
Published by the NHS Learning Resources Centre
25
tJ/ie
^ctaneuH)^c
THE 0RGAN1SAU0H OF COURSE CONTENT
Jerome Bruner (1966) says "... knowledge which
has been acquired without sufficient structure to
tie it together is knowledge that is likely to be
forgotten. An unconnected set of facts has a
particularly short half-life in memory".
Taking into consideration the course aims and the
learning needs of the students, list the main
topics, subjects, experiences or concepts which
you feel should be incorporated into your course.
This list should be organised to show the relation
ships of each item, for example,
Healthy Old Age
1
The course may
be planned in
Support
in the community
for the aged
. 1.
sequence, each
section building
on what went
before
Care in hospital
l
Rehabilitation
This example reflects to me the general philosophy
of the Nursing Process in its approach i.e.
considering first what is 'normal*, then what
contributed to the breakdown of health and how we
might plan to work towards rehabilitation to the
norm for each individual.
The organisational thread running through a course
may be a major theme, such as 'prevention of cross
26
infection’ in a course of study in operating room
techniques thus providing eoivtiviLLCty.
Other elements may be introduced relating to main
themes, these should be
appropriately
e.g.
Social
Services
MAIN THEME
Health Care
Teams
Support in
the Community
for the aged
Voluntary
Bodies
Religious
Organisations
This may be quite a simple matter, it might be
extremely difficult or there may be several
choices open. It is necessary to keep the course
aims in mind and continually ask yourself "What learning experience will be useful?
"What points do I want to emphasise?" "Wliat
information might the students need?"
If an organising thread is not immediately obvious
you may find it useful to make a ’map’ (Buzan 1977).
You may like to try the following exercise.
The main topic is written in the centre of a large
sheet of plain paper. Sub topics are added, rather
like branches of a tree in any order or position.
Themes or concepts can be built up easily and
quickly making smaller branches. This technique
allows a free flow of ideas at an early planning
stage. Example 1 (Figure 3a, b and c) shows
how you might approach a plan for an Introductory
27
Course incorporating the philosophy of the Nursing
Process.
The Nature
of Man
The
Learner
Introduction
The
Organisation
to Nursing
Nursing
Process Skills
Practical
Skills
Figure
3a
Preparation
for encounter
with patients
Making a Concept Map
28
Maslow* s
Hierarchy
Confidence/Self Concept
Growth and
Developmen
I
Personal Development
and Growth
The Nature
of Man
Study
---- The
Skills
Learner
The
Organisation
f
|
Introduction
to Nursing
Preparation
for encounter
^with patient
\
/
Ethics
\
Team Work
Practical
Skills of
Nursing Care
Responsiblity
\
- Maintaining
comfort
Body Mechanics
Safety
Hygiene
etc.
Figure
3b
Making a Concept Map
29
I
I
Nursing Process |
Skills
I
- Nature of
I
nursing
- Total Patient
Care
I
c)
Listening Skills
listening to
feelings
Perception
Talking
to a
patient
Personality
characteris tics
Preparation
for encounter
with patient
Initial
encounter
Human
rights
Building
relationships
Maintain a
relationship
Working
toge ther
Figure
3c
Enlarging on one aspect of the
’Main Theme’ concept map
30
2
Example
The
Family
Unit
Woman in
Society
The Family
Unit
_i
and Care of
newborn
OBSTETRIC
EXPERIENCE
MODULE
.
Woman
in
Pregnancy
7
Role of
Father
Woman
in Labour
Figure
4a
Shows an early plan of an Obstetric
Experience Module
31
co
si
GJ I
^uerperium
es tablishment of
feeding
care of
newborn
&> X
OBSTETRIC
EXPERIENCE
woman in
pregnancy
\c>
WOMAN
IN
LABOUR
>
V
\
Va
I
L
<s>
A
B
0
U
R ,
father’s
supportive role
observation
^ysi°lo
resusci tation
Figure
4b
A Later Plan
32
(OO
Hie
Nurse
The
Organisation
Introduction
to Nursing
Law
Ethics
The Needs
of Man
The Nature
Of Man
Development
Bio/Psycho/
Social
Effective
Communication
Skills
Evaluating
Basic Nursing
Skills
Practical ---^-****
Skills
Assessing
Problem Solving
Skills
Figure
5
Organising related Concepts and Themes
(from Fig 3a,b andc. Introduction to
Nursing)
33
This exercise may also help to break down rigid
patterns of thought and help you to view your
topics from a different perspective. Well
organised material can influence greatly the
efficiency of instruction.
The next stage is to organise the material in
relation to the time you have available and
within your identified constraints. If you find
that you have many more topics than time
available, look again at your aims and decide
on priorities.
The next stage of your plan might look like
figure 5, which suggests how the maps on
figures 3a, b and c might be organised.
Suggested KqAZoyi
4
Draw your conceptual maps
Organise related concepts and themes into
units or modules
Consider the time you have available and
try to allocate the material
appropriately
Consult with subject specialists for
comments on course framework
34
Learning objectives identify what is to be learned,
whilst aims for a course are general statements of
a teacher’s hopes: Objectives are concrete state
ments about the student’s learning activities.
A statement of objectives may not define every
thing that may be learned, nevertheless it focuses
both the teacher’s and learner’s mind on central
issues which must necessarily be mastered.
Attention is focused on learning rather than
teaching or subject matter e.g. the learner may be
required to:-
identify . .
demonstrate skill in . .
list . . .
explain . .
describe . .
write . . .
Advantage ofi de.^iZng obje.c£l.veA
(Vavd^
1971)
they provide a complete summary of the
course for the teacher
they provide the learner with a clear
account of what he/she is expected to
learn/do
they enable the teacher and the learner to
distinguish between different varieties
of behaviours and so help them decide
which learning strategy is likely to
be optimal
they ensure that measurement is possible
so that the quality and effectiveness
of the learning experience can be
evaluated.
35
Mating ob j”ctivu>
GcncAoZ
G^tonZand 1970)
The performance required from the student
should be stated, not that from the lecturer.
The learning outcome is stated not the process.
When planning a course, objectives are usually
stated in broad, general terms and become more
specific at the level of student/teacher inter
action.
cua/iZcuCujm obje,c£cve,*>
VsCA&ctci Nu/tA'ing'* cou/lac..
ExcunpZeA
^om fCu/L^cu£um
"To assess and meet the nursing needs of
patients in the community.
To apply skills and knowledge and to impart
them effectively to patients, relatives,
other carers and the general public.
To be skilled in communications, establish
ing and maintaining good relationships
and able to co-ordinate appropriate services
for the patient, his family and others
involved with delivery of care.
To have an understanding of management and
organisation principles within the multi
disciplinary team and a positive approach
to future developments to meet health care
needs.”
*
Taken from:
Curriculum in District Nursing for State
Registered Nurses and Registered General Nurses.
Drawnup by the Panel of Assessors for District
Nurse Training.
36
If you are planning nursing experience modules
using the framework of the nursing process, you
may wish to consider the skills which are needed
for the practising nurse for each step of the
process. For example:1.
Interviewing
-
listening
awareness of own prejudices and values
Observation skills
Measurement, recording, classifying
Inferring from information received
Comparing, identifying
Discriminating, judging, analysing,
synthesising
2.
PZanncng 'ShZCLs
Analy sing
Goal setting
Objective stating
Prescribing action
Identifying
Priority stating
Hypothesising
Communicating
3.
ImpZemejitlng
Organisation skills
Communication skills
Interpreting
37
Inferring
I
Re-assessing
Judging
Psychomotor skills
EvaZacuUnQ
Defining criteria
Assessing information collected
Assessing own behaviour
Assessing others’ behaviour
Judging
Interpreting
Adapting
Communicating
SuggeAtad Action
5
Consider the course aims you have written
and the framework of the main concepts.
Take each module or unit of Learning in turn
and write the first draft of objectives for
the course
Ask for constructive criticism from
colleagues.
38
Books you may like to refer to:-
DAVIS I K (1976)
Objectives in Curriculum
Design
Pub. McGraw-Hill Book Co.
MAGER R F (1962)
Preparing Instructional
Objectives
Pub. Fearon Publications
REILLY D (1975)
Behavioural Objectives
in Nursing
Pub. Apple ton Century Crofts
Appendix A gives an example of how objectives
may be written, relating Nursing Process to ward
and school experiences. (Pages 70-78)
39
By defining desired educational outcomes, the
curriculum builder has the most useful set of
criteria for suggesting learning experiences.
Decisions about what learning experience will
best help the learner to achieve the stated
objective must now be made.
Learning takes place through the active behaviour
of the student rather than anything the teacher
does. The teacher may be giving an excellent
lecture on Otitis Media, and two students, sitting
side-by-side in the class,may be having very
different experiences. Student A has been work
ing on ENT ward and is relating and making connec
tions with her experience and past knowledge of
the anatomy of the ear. Student B however, may
have a GNC assessment the next day and be plan
ning how she will cope with that experience. The
teacher can, however, help to enable learning by
selecting learning experiences with which the
students can react and which will match your
educational objectives. The emphasis here is
firmly on learning and the learner - the teacher
is seen as the manager of the learning and the
learner as active participant.
Gene/izzZ
The choice of learning experiences will vary with
the kind of objective aimed at, but there are some
general guidelines.
1.
The student must have experiences which give
him opportunity to practise what he has
learned e.g. if the objective says . . . ’’the
student will develop skill in problem solving”
this cannot be attained unless the student has
40
ample opportunity to practise solving
problems.
2.
The learning experiences must be such as to
give the student some positive feedback
that he/she has learned ’correctly’, that
what has been learned is seen to relate
to his work or experience, that some good
use can be made of this knowledge or
skill and that the information provided for
study must be valid, up-^to-date and related
to the learner’s needs.
3.
The learning experience planned must be
related at some point to the student’s
knowledge or experience i.e. the teacher
must begin from where the student is.
4.
Different learning experiences can be
used to meet the criterion of a part
icular objective, thus the teacher has
a wide variety of choice at her disposal
when planning particular activities.
5.
The same learning experience can bring
about several learning outcomes. A well
planned set of learning experiences can
be economical in terms of time.
Before considering which learning experience will
best help your students achieve their objectives,
you may wish to read through the following list
of strategies or approaches (Bligh 1972). It
represents some of the techniques and tools the
teacher may use. The good teacher will have
a variety of approaches in his or her repertoire
of teaching and facilitating skills. Approaches
which demand the personal involvement of the
student are more likely to be effective.
41
APPROACHES
COMMENTS
* B/icbCKi StoAmZng
A technique which
encourages the
generation of new
ideas and solutions
to problems. Items
are listed randomly
as they come to mind,
initially suspending
all criticism. Ideas
are later submitted
to analysis,
synthesis and
evaluation
Useful in helping:- to foster creative
thinking and genera
ting original
solutions to problems
- to plan projects or
solve individial
problems.
This is difficult to
manage in large groups
(8 - 12 a reasonable
number).
* Buzz GA.ou.pz>
A form of discussion
group where a large
group divides into
sub-groups to consider
briefly a specific
problem.
Everyone gets a chance
to contribute and a
cross section of opinion
can be gained in a very
short time. A clear
definition of the topic
is essential.
* Ccosc. StucLi^
Real or simulated
problems are analysed
and possible solutions
to problems are
discussed.
Encourages the explora
tion of complex inter
relationships. Good
method for helping
people to participate
orally, to think through
and ’feel into’ the
roles of the persons
concerned in the case
s tudy
participants must
be given adequate
information and
enough time for
reasonable
discussion.
*
Visual presentation
of a technique, process
or skill, accompanied by
explanation of facts,
concepts and principles
to be learned.
An effective method in
helping to link theory
and practice.
- learning objectives
must be clear to
s tudents
- everyone must be able
to see and hear
- each learning step
should be understood
before proceeding to
the next one
- participation and
practice essential
for learning
- requires careful
planning and
rehearsal.
* V'CACUAA-COn
- encourages develop
ment of the thinking
process and a will
ingness to receive
A group activity which
involves sharing of
ideas. It may take the
form of:-
43
- and consider new
ideas
group tutorial general topic and
direction given by
the teacher
more effective with
small group
- free discussion
topic and
direction
controlled by
students.
- is time consuming
- difficult to evaluate
learning
- if teacher centred good leadership
is necessary
* Leetu/ie.
- presents prepared
information to a
large group in a
short time
A formal talk on a
specified subject.
A one way communica
tion, giving informa
tion or instruction.
can be used to
introduce a topic
for in-depth work or
to summarise
we generally remember
about 10% of what we
hear
- teachers cannot tell
if concepts are being
understood
information could be
given as a ’handout1.
* P/io/ecZd
encourages students
to be self-directed
to some degree
- may be individual
or group activities.
44
An in-depth treatment
of a topic which may be
teacher chosen but is
generally student
directed.
*
- requires commitment.
PZay
The unrehearsed drama
tisation of a human
relations problem, to
help participants to
become aware of others’
feelings and ideas.
- allows participants
to experiment with
new ways of behaving
or reacting
- situations can be
devised which fit the
learning needs of the
students
- the participants need
to be sensitive and
open minded
- careful planning and
clear understanding
of learning goals is
necessary.
*
Simatattcm Gam^
Essential features of
a real situation may
be presented in
simulated exercise.
- can encourage
discussion and ideas
sharing
- may improve problem
solving skills.
45
should also be
mentioned here although some of the above could
be classed as ’experiential’. The teacher, as
facilitator, designs exercises to help the
learner (as an individual) explore specific aspects
of a given behaviour e.g. to experience listening
in a simple exercise with another person, when
considering basic communication skills.
The way we teach has a profound effect on students.
They have often been conditioned to expect the
teacher to qZvC all the information. This re
inforces the belief that only ’teacher type
information’ is valid. Students should be incouraged to use deductive methods, learn to
appZt/ the concepts, theories and principles and
gain confidence in their own problem solving and
decision making abilities. This approach can
bridge the gap between theory and practice and
build up the student’s confidence in their own
abilities.
The teacher’s role is flexible and changes
appropriately in relation to the demands of
different situations as giver of information
as manager of learning or
as facilitator of learning, enabling others
to learn for themselves.
Look again at the Nursing Process Skills on
page 37. An information base is essential before
we can engage in complex decision making and
problem solving activities, but students who are
oyiZy given information will be ill equipped to
cope with this approach to nursing.
46
Suggested Actcon
6
Consider each objective you have written.
List learning experiences you feel will best
help tbe learners achieve them, bearing in
mind that practising a skill will lead to
proficiency.
Can you suggest other factors which will
encourage skill acquisition?
FURTHER READING
BLIGH D A (1972)
What’s the Use of Lectures?
Pub.
MARSON S N
(1979)
Penguin
Nursing - a helping
relationship
How to Choose Appropriate
Training Techniques
Pub.
PFIEFFER &
JONES
(1978)
(in seven
volumes)
Nursing Times 1979
A Handbook of Structured
Exercises in Human Relations
Training
Pub. University Associates
47
ROGERS J
(1977)
Adults Learning
Pub.
SCHWEER J &
GEBLINE K (1976)
OU Press
Creative Teaching in
Clinical Nursing
Pub.
48
C V Moseby Co.
CHOOSING ANV USING AUV1O VISUAL TEACHING AWS
AND SUPPORT MATERIAL
Selecting media is a very subjective exercise
Audio visual aids, if used well, can widen the
channels of communication between teacher and
staff. The concept of teaching which is based
solely on the teacher’s voice and personality
stems from the belief that communication is best
achieved through the medium of sound. The user
of audio visual aids believes that he can also
communicate effectively through sight and touch.
When the ’real thing’ is absent, film,video,
model, sound recording etc. can be incorporated
into a lesson, supplementing the teacher’s
explanation, reinforcing, providing interest and
motivation, improving instruction, students’
understanding and retention.
Your choice of material to support or aid you as
a teacher should be based on the learning
objectives primarily rather than on what is
easily or ’freely' available.
49
UAsing aacLio v.-uctaZ aZcii
Certain questions should be asked by anyone using
an aid:will the use of this aid help to attain
the learning objectives?
what responses or action do I require
from the students?
how shall I evaluate this?
Unless the aid you choose does help you to enable
learning you may be well advised not to use it.
Another question you might ask is - at this stage
of my lesson/course/demonstration, which type of
aid will best suit my purpose?
what is its purpose?
does it specify objectives for learning?
does it specify who it is designed for?
does it relate to the syllabus and the
aims of the course?
does it assume or build on previous
knowledge of the learners?
is its content accurate, up-to-date and
well presented?
is its sound track clear and length
appropriate?
will my particular students find it
interesting?
50
Some of the surprise
elements may be
eliminated by
previewing media
before use in a
presentation.
Suggested Aa£ccm 7
Consider what resources you need for each
learning experience planned.
Consider what material you have access to in
your own area.
It may need up-dating,
adapting, restructuring or just collecting
together to be of use to you.
51
Evaluation is a strange mixture of values and
science. In everyday English usage it suggests
judging the work of something and that may raise
questions like "Who is judging?" "What is being
judged?" and "By what criteria?" These questions
may be viewed simply and answered naively but the
problem of evaluation is an extremely complex and
difficult one.
Evaluation is a fundamental part of curriculum
development. Its function is to identify aspects
of a course where curriculum revision is necessary.
It may take place at five levels.
As an ongoing process during the planning
stage when decisions are being made about
issues such as "Which aims, which
objectives, which teaching method or
resource and how shall we evaluate? II
Evaluation of the ongoing course, of the
objectives set, the methods and media
used or the educational practice of the
teachers.
An assessment of students' achievement
of the objectives set, judging student
performance for purposes of selection or
grading, feedback to student of progress
or deficiencies.
Longer term or follow up evaluation data
may be collected from the ex-course
members or the supervisor in the service
area where ex-course members are working.
Information requirements at organisation/
administration level.
52
Rather than get into deep water in this brief
introduction to such a complex subject, I would
prefer to point you to some of the literature
and confine myself to comment on some of the
issues presented.
The. Au.bj'e,c£cve ncutivie. ofc wcoTijuittoYi
Anything other than the single objective test or
multiple choice question test gives rise to
problems of decisions about values, both students’
and teachers’ values e.g. two teachers may grade
an essay on ’factors affecting the elderly in the
community’ very differently. Have we any
guarantee that what students say they will do on
paper has any relation to what they will do in
practice (Bendall 1975)?
Hou) much uaz do u)c make ofc student fceedback?
We can collect some fairly factual data by asking
questions such as:Were there too many lectures, too few
tutorials, not enough practice?
Do the students find the work load
too great?
Was the information presented difficult
to follow?
Did the students have enough support as
a learner
- in the classroom
- in private study
- in the practical setting?
Did students feel they were prepared
adequately to cope with their practical
experience?
53
This type of questionnaire can provide useful
feedback for the curriculum planners; provided we
are clear about what we are trying to do, and can
put to the students well structured questions
seeking the kind of information which will help
decisions about how courses should be modified, or
how teachers should try to alter their behaviour.
(Eraut 1977)
"Feedback to tuto/i a^te^ a coatee emptoytng
a student ddAected approach to Atady
bktttA.
'Tht^ has been the stopptest and most
dtsostgantsed cou/cse I have eve/i
taken. 0^ cou/cse I have made some
psiogstess, but thZs was due enttsiety
to my own e^on^ts. . . ' "
Lza/insing to Study
G/cahani GtbbA
OU Pabttcatton
Hou) much do tcacheM gatn ^hom havtng thctsi u)o/tk
cxamdncd?
Perhaps as the teacher sees it - very little. We
must recognise that "human kind cannot bear very
much reality". (T S Eliot, Burnt Norton). The
risks involved in receiving detrimental feedback
from our colleagues/students/administrators are
great. We may discover that the students do not
really care for us. We risk damage to our ego
by finding out that we are not doing our job very
well. Finding out about one’s deficiencies can be
a painful business and very few of us enjoy being
evaluated.
54
If we consider nurse training and education along
a continuum i.e.
basic
— skills
training
pos t
• basic
education
s taf f
development
■>
assessment is relatively simple at most levels on
the left hand side of the scale, e.g. a student
who gives an intramuscular injection into the
upper outer quadrant of the buttock, is more
likely to succeed than the student whose action
causes paralysis of the sciatic nerve. There is
no debate about the many life and death issues
on a nurse training course. At the right hand
side of the continuum however, where decision
making or open ended questions are involved,
evaluation issues are complex.
The purpose of assessing students may be:-
to provide the basis for guiding the
learner’s progress
to determine whether or not the
behavioural objectives specified
have been attained
to assess the success of the
instructional strategies
employed
to provide the learner with know
ledge of his/her attainments
to help the individual learner
identify his/her own strengths
and weaknesses
to provide a diagnostic means of
identifying learning difficulties
to determine whether it is
55
appropriate to continue with the next
learning sequence.
Assessment in this case is usually related to
specified behavioural objectives.
Some of the assessment tools available to the
teacher are listed below.
EMtOlJ qCL^tZ0Yl6
These measure the learner’s ability to organise
information and think logically, clearly and
relevantly. They can provide information about
an individual which will influence future teaching e.g. value judgements expressed and attitudes
adopted which may be incongruent with the
educational goals of the course.
TeAtb
Short answer tests can be useful to measure the
extent to which the learner mastered theoretical
information e.g. multiple choice, true and false,
sentence completion, filling in missing words e.g.
to test factual knowledge on structure of Social
and Health Services.
Advantages - they are easy to score and save time,
providing instructors with basic information about
what has to be learnt and pinpoint general
weakness.
Students can be asked for views and encouraged to
think about their own frame of reference. The
technique allows for flexibility and generates
56
spontaneity.
Weaknesses - the possibility of developing un
favourable reactions between interviewer and
interviewee. Interviewee may be disadvantaged
because of note taking or recording devices
which can prevent free response and communication.
Code
The learner must solve or handle the problem
presented by choosing from a list of possible
solutions or by writing the proposed solution to
the problem, listing steps taken.
Project u)o/dz
An in-depth study of student’s own choice, related
to course objectives,aimed at increasing student
involvement in a specific area. There is a list
of suggested project subjects in the Joint Board
of Clinical Nursing Studies outline curriculum
in Geriatric Nursing Course No. 296.
Projects test the learner’s ability to:- acquire and use information
- develop problem solving ability
- keep up a sustained effort with supervision
- produce work of an acceptable standard
Rating -6c.at^
A technique which attempts to assess attitudes
of groups. It may be a teacher-rating, an
observer-rating or self-rating. None of these
techniques can be used with much confidence for
57
precise assessment of an individual but a group
of individuals can be assessed with relative
accuracy, for example, the teacher may wish to
assess the attitude to a particular learning task.
A teacher-rating scale might look like this.
Mafee you/L /icctcng on each, ofa the. fiottowtng
attctude^ by ptactng an X anywhe/te. along the. tine,.
Looks bored
Does not get
work materials
out or prepare
to start
seems about
as eager as
the rest of
the group
Ready to
begin
appears
animated and
eager to
learn
There are many forms and uses e.g. a detailed
breakdown of the behavioural objectives for a
specific task can form a useful evaluatory
instument for assessment of a student’s perfor
mance Of that task. These are clearly observable
events which either occur or do not. Thus a
carefully composed checklist can form a reliable
basis for judging proficiency. Check lists may
also be used by the learner to evaluate his/her
own performance. A criterion referenced check
list can provide a major source of constructive
feedback for student assessment.
58
Students should be encouraged to take an active
part in evaluating their own performance. This will
involve them in identifying their own strengths
and weaknesses and choosing their own learning
objective (in addition to those already selected
by the teacher). Some of these selected personal
goals may be in the affective domain e.g. related
to personal values or feelings of confidence.
These are usually difficult to measure. For example
a student may say he/she feels very anxious when
having to talk to the mother of a sick child.
After discussion of specific instances and an
attempt to isolate specific causes, practice may be
organised with peers in role plays or discussions.
The student may then be asked to report back in an
agreed specified time to discuss her levels of
confidence and competence.
The value of this approach is that it encourages
the students to take more responsiblity for their
own learning, to be self-directed in context.
It
encourages students to take a constructively
critical approach to their own development personal and professional. They will then be in
a better position to appraise the behaviour and
performance of others.
CcuMe app/taZioZ
It is essential to gain feedback from the course
participants on the effectiveness of the course on
points of:~
relevance to their job
usefulness of learning experiences
provided
-
suitability of learning aids
59
length or enjoyment of sessions
A simple rating scale may be used. If some
experimentation is taking place i.e. new course
and new teaching methods being employed, a rating
scale which is short and can be filled in at
regular intervals throughout the course may provide
more useful feedback to the course organiser than
one long end of course evaluation questionnaire.
e.g.
Amount of learning during session
1.
I_____ I
J_____ I
I
taught me
a lot
taught me a little
I did not know already
Relevance to my work
2.
I
I_____ I___
I_____ I
very relevant
not very relevant
As a learning experience
3.
I
I
J_____ I
I
difficult to
unders tand
easily understood
|______
enjoyable
1
I___
I
I
boring
1
1
J_____ I
too short
too long
1
I_____ I___
relevant to course
objectives
1 ___
l_____ I
not relevant to
course objectives
60
Examples of more complex course appraisal forms
can be found in the Joint Board of Clinical
Nursing Studies publication - Course Evaluation
package on the design of tests you might wish to
refer to.
Appendix B offers another approach for looking
at curriculum in practice.
(Pages 79-88)
FURTHER READING
BOREHAM N C (1977)
The use of Case Histories
to assess nurses’ ability
to solve clinical problems
Pub. Journal of Advanced
Nursing 1977 Vol 2 pp 57-66
FIVERS &
GOSNELL
(1966)
Nursing Evaluation - the
problem and the process
Pub Collier Macmillan
London
HOUSE V G
(1977)
Evaluation research: The
need for multiple criteria
Pub Journal of Advanced
Nursing 1977 Vol 2
pp 15-20
JOINT BOARD OF
CLINICAL NURSING
STUDIES
(1978)
KEHOE D &
HARKER T
(1979)
Evaluation
available from Joint
Board of Clinical Nursing
Studies
Principles of Assessing
Nursing Skills
Pub
61
Pitman Medical
MACKINTOSH H G
Techniques and Problems of
Assessment
a practical
handbook for teachers
(1974)
Pub
OPPENHEIM A N
(1976)
Questionnaire Design and
Attitude Measurement
Pub
ROWNTREE D
Harper & Row
Measurement and Evaluation
in Psychology and Education
(1969)
Pub
Saggert^d kc,tioYi
Heinemann
Assessing Students - how
shall we know them?
(1977)
Pub
THOMDIKE R &
HAGEN E
Edward Arnold
Wiley International
8
Consider what assessment techniques you will
use to help ascertain if learning objectives
have been achieved.
Consider what strategies you will employ to
evaluate design issues and implementation of
the course you have planned.
62
This book has been designed to offer
curriculum planners some practical
ideas which will guide them in the
design of a course. I am aware,
however, of the danger of over
simplifying some very complex
issues, of trivializing concepts.
I would urge readers to deepen
their study of this very interesting
subject.
Curriculum reform can be a very real
instrument for change in an organisation.
To be effective, however, we need
planners with courage, conviction and
a creative flair.
63
BAUME A D
JONES B
BENDALL E
Edacatcon btj
&
(1974)
Longman
(1976)
Journal of Advanced
Nursing Vol 1 No 1
January 1976
BLOOM B S
(1972)
Taxonomy ofa EdacaTTonaE
Obje,e£iveA
Longman
BOWMAN M
(1976)
The, Cu/b^ccaEam and The.
Nursing Mirror Vol
9 September 1976
BOYDELL T
(19
)
Expe/bLe.nTLaE Le.aAnx.ng
Manchester Monographs
No 5 Dept of Education
University of Manchester
Manchester Ml3 9PL
BRUNER J
(1966)
Totca/ids a Thearty o^
iM&Luation
Harvard University Press
BUZAN T
(1977)
Il6e you/i Head
BBC Publication
CLARK C C
(1978)
C-EaAA/LOom SfexZfA
A/u/tie EdaoatosiA
Springer Publishing Co
New York
64
COFFEY L
(1975)
Modtiics f^o/i IndependentIndividual Learning In
Na/islng
F A Davies
DAVIS I K
(1976)
Philadelphia
Objectives In CuMlculum
Design
McGraw & Hill
DAVIS I K
(1971)
The Management o^ Lea/tnlng
McGraw & Hill
ERAUT M R
(1977)
CouMe Evaluation - A Ccose
Study
Conference papers No 7
Staff Development and
Educational Methods Unit
Manchester Polytechnic
GAGNE R
(1970)
Tlie. Conditions o^ LzaAntng
2nd Edition
Holt, Rinehart & Winston
HEATH J
(1979)
Ca/ie o^ the Elderly: A
euMlcutcuii guide fio^ thoAe
Involved In teccchlng In
hospital and community
2nd Edition
NHS Learning Resources Unit
HIRST P H
(1970)
T/ie. Logic o^ the CuMlculum
Journal of Curriculum Studies
Vol 2.1
Taxonomy o^ Educational.
Objectives
KRATHWHOL D R (1956)
e t al
Handbook II - Affective
Domain
David McKay Company
New York
65
McGAGHIE W
et al
(1978)
CornpeXenc(/-Bcued Ca/LU.cuZtun
PeveZoprneFtt Zn MedZcoZ
EdacaZLoyt
WHO publication
MAGER R F
(1975)
Geneva
Pncpantng la6tnacttonat
Objective*
Fearon 2nd Edition
Belmont California
MARRINER A
et al
(1980)
CaMtcutcun Evataatton:
U/o/dz, Fact, Rttuat on
Pc.aCi.tLj
Nursing Outlook
April 1980
MARSON S N
(1970)
A 'SyAtemA' Approach to
Edacatton and Tsiatntng o^
Nau e.-6
Nursing Times
MARSON S N
(1979)
9 July 1980
Nautng: A Hctptng
Pctattoashtp
Nursing Times
29 March 19 79
REILLY D
(1975)
B 0 Zn Nu/Msing
Appleton Century Crofts
REILLY D
(1978)
T2.ac.btng and Evataattng
the. A^ecZtve Vomatn tn
NaUtng P^og^ammcA
Charles B Slack Inc
ROGERS J
USA
(1977)
OU Publication
ROBERTS K
(1981)
1 Futu/itztng1 the. Cannicutuni
Australian Nurses1 Journal
Vol 11 No 3 September 1981
66
ROWNTREE D
(1976)
Hocu to Study
Macdonald & Jones
London
SOCKETT H
(1976)
PzAtgntng the CuMtcatiuji
Open Books London
STARPOLT C &
WALTX C
(1978)
Pevcf-cpZiig and Evatuattng
E dueatto not Psw g/tamA
Heatth Co/lq, PsicjvtdeAA
F A Davis Philadelphia
STEEL S
(1978)
EdLLcationa.^ OvjzctiveA
Lyi MuTuZng
Charles B Slack Inc USA
STENHOUSE L
(1975)
An Intwdactton to
CuMtcutum Pe^ca/tch. and
Vevctopmznt
Published Heinman
RABA H
(1962)
I/ieoAt/ and P/iactEce
Harcourt, Brace & World
TENNYSON C
et al
(1978)
EvaLaatton tn CnAAtoaEam
V^ve£opme.nt
Educational Technology
September 1978 pp 52-55
TYLER R W
(1949)
■S(L6Zc Pntnctpte,*
CaMtcatani and InAtfuictton
2nd Edition 1971 Univeristy
of Chicago Press
67
BIBLIOGRAPHY
(references to the Nursing Process)
BEVIS E 0
CuA/ileulum Building In
Num Ing A PAocett
(1973)
C V Mosley
St Louis
CLARKE M
Planning Nu/iAlng Coaq,
Nursing Times
16 February 1978
CROW J
The, NuMlng PAoeett PoaI 1
The^oAello BackgAound
PaAl II How and Why to
Take a NuAtlng
Hit toAy
PaAt 111 A NuMlng Hit to Ay
QaettlonnalAe ^oa
two Patlentt
Nursing Times
30 June 1977
16, 23 and
Problem Solving Sklllt
(Uh.at
doM zdaoallon
have.?
FEDERICKSON K
& MAYER G G
American Journal of Nursing
Vol 7 pp 1167-9 July 1977
It's a Taxing Pslocaaa
HEATH J &
MARSON S
Nursing Mirror
23 August 1979
A New Kind
HEATH J
Nu/ue,
Nursing Mirror
9 August 1979
HUNT J &
MARKS-MARAN D
Num Ing CaA^ Plant
Published
(1980)
68
H M & M Publishers
KRATZ C
Hte Nibbing Psioqma
Nursing Times
9 June 1977
McCLURE E
TTie Mccuing PficnMA
Studios in Tottonio
Nursing Mirror
2 October 1975
(VfcaZ do m mean by Co/lq.?
McFarlane j k
Nursing Mirror
2 October 1975
McFarlane j k
A ChasiteA fpn. Caning
Journal of Advanced
Nursing Vol 1 pp 187-196
1976
McFarlane j k
VzoeZoping a Theory o^
Nanking
Journal of Advanced
Nursing Vol 2 pp 261-270
1977
REILLY D
BefcavZou/iaZ Obje.ctcveA in
Nuking
(1975)
Appleton Century Crofts
New York
ROPER N
A MocteZ
Mauoiogy
Nanting and
Journal of Advanced
Nursing Vol 1 pp 187-196
1976
69
^/tjiendix
fl ncm kiftd of nur/c-l
f 'W'N PLANNING any educational
I training programme, certain defined
JLcriteria will guide the decision-mak
ing process of the designers. Criteria
which influence the nurse educator
might be the needs of the service area,
the knowledge needed by the nurse to
perform her role safely and efficiently,
and the constraints of the organisation.
This article examines some further
points which add other dimensions
(Figure 1) and could have profound
elfects on the leaching/learning scene. In
some cases, this may require a rethink
mg of firmly held values and philos
ophies.
Factors affecting curriculum design
include:
• The GNC document on educational
policy, 1978-79, states that there should
be a commitment by the training estab
lishment to provide a "good climate for
learning”, and a “sequence of learning
units which enables full integration ol
theory and practice".
• The nursing process requires that pa
tienl care should be considered systema
(ically, that (he patient should be seen as
an individual in an emotional and social
context and (hat planning will involve a
problem solving approach which en
courages not only evaluation of one’s
actions, but self examination of the
reasons for decisions arrived al.
• In similar vein, the GNC statement
on the profile of professional responsi
bility, which was drawn up in connec
tion with nursing directives for the EEC,
asked that the nurse should observe, as
sess and stale a patient’s needs, com
municale with patients, relatives and
colleagues, and critically assess and
evaluate her own work and that of her
colleagues.
• A search for the identity of nursing as
a profession. A great deal of questioning
is going on about what nurses do and
why they do it. Nurses must supply the
answers and learn to be accountable to
those they work with and for.
• An increase in management tiers has
led to the need to improve the nurse’s
management qualities. Al different
levels, she learns to become a decision
maker.
• Society's expectations are changing.
Most people now wish to be informed
and consulted on decisions being made
about themselves or their close relatives.
The nurse must learn to be a communi
calor.
• A multidisciplinary approach to
many health problems makes it neces
The author is Information OJJicer,
NILS Learning Resources Unit.
Sheffield City Polytechnic.
Tomorrouj /
approach
to learning
Jean Heath, SRN, SCM, discusses the issues the
curriculum builder has to consider and the shift to
student-centred styles of learning for tomorrow's nurse,
sary for a nurse to be informed about
wider issues. The nurse must learn to co
ordinate the work of other professionals,
seeing the patient as the focal point of
interprofessional expertise.
In the past, we have primarily asked
the question: What do we want the stu
dent to know? But increasingly, in (he
light of (he factors I have mentioned, we
are having to consider a further ques
lion: What kind of a person do we want
at the end of the training process?
In reply to this second question. I sug
gest we want a nurse:
who is not only informed and skilful
but who can apply her knowledge and
skills in different medical, institutional,
social and interpersonal situations;
who is confident in her ability to plan
and to implement those plans - that is.
to think constructively and arrive at
reasonable alternatives quickly;
who is emotionally stable but flexible
enough to give and take evaluation;
who is secure in her professional sell
identity and increasingly aware of the
complex factors involved in the effective
operation of team care;
whose actions are comprehensive,
logical and efficient in performing her
role/function;
who can see her patient as a whole
person with background, relationships,
value systems, etc, (hough these may
not be obvious at the first meeting
between nurse and patient.
In planning training courses, whether
in further education or nursing, course
designers often appear to und<T<-innate
the importance of standing back and
assessing those qualities (hey would like
to see in the end product. Energies are
all too quickly channelled into subject
matter to be included, provision of ex
periences. organising timetables, with
the emphasis on “covering" everything.
The central theme of this article is
that (he kind of nurse needed to irnple
ment the nursing process will necessitate
great changes of thinking of altitude and
practice in both teacher and learner.
Much has been written recently on the
nursing process, but it contains little
comment on (he implications for the
schools of nursing As an educational
technologist. I would like to add to the
general confusion or otherwise, by offer
ing yet another viewpoint
The GNC gave us a major clue when
it suggested that consideration be given
to providing (he right climate for (each
mg and learning. This climate was not
defined and one is left to interpret it or
ignore it.
Tom Boydell discusses the establish
ment of a learning climate as "one of
trust, mutual support, acceptance of the
individual, warmth and respect". In such
a climate, the learner can take risks (in
the sense of trying out new behaviours),
admit to difficulties and problems, give
and receive feedback and cope with the
allied stress.
The prime function of the teacher is to
facilitate learning. No one would deny
there are a great many facts to be
------ TODAY —
YESTERDAY—|
Nursii kj process
Ne<j<ls of service area
Subject ntaner ——
CURRICULUM
Skillsneeded —
DESIGN
Organisational
X.
EEC nursing directives
<>N(. i.Kluc<itional ixMicv
ChaiHjiiu) needs of society
___________ COI isll.IH I Is________________
Figuto I Factors affecting curriculum design
70
Mm.-i
\ui-.iist ■' Iv74
TEACHER TACH IIATOR
f riconrages students
■rctivefy to take
rescxinsilrrlitv lor own
insight into IIhmi own
sfnrngfhs and weaknesses
Oiienrwss and acrreiitarice
in relationships,
nrcognises her own
limitations. Has tlie
\
necessary knowledge and
is able to provide
rrMevant res<Mlices.
STUDENT
Willingness to lake
mspr insit rrlity lor
own learning
to i.o op>*r.it> witli
others
to set own learning
goals
to evaluate own
performance
A
LEARNING
CLIMATE
Commitment to personal
growth and development
Co-ofieration and teamwork
Commrtnwnt to educational
aims
Siipoort for indtvidrials
Mutual respect
and trust
Figure 2: The learning climate,
learned, but how might they be learned?
How can we arrange the learning experi
ences so that at the end of the process
we have not only informed, but also
confident, planning, decision-making,
communicative nurses?
An exaggerated emphasis on teachers
and teaching can have a detrimental
effect on learners and learning. This is
be able to recognise and accept her
own limitations;
involve the students actively to
assume responsibility for their own
learning;
have a base of knowledge and per
sonal security from which to operate.
not a new thought. Cicero is quoted as
saying: “The authority of those who
leach can often hinder those who want
to learn." Teachers might ask them
selves if they have confidence in people’s
The student who would fit into this
new learning climate is seen as a co
worker. She must take more responsi
bility for her own learning if she is to
discriminate, make decisions, plan, etc.
ability to learn and if they create condi
lions in which people are actively
encouraged to learn.
Consider the following:
The elevated status of the teacher tends
An open learning environment cannot
become available unless and until the
student meets the teacher with willing
ncss to share the work.
Students of nursing tend to see their
real training taking place primarily by
the patient's bedside. If an integrated
training programme is implemented, the
student may begin to see the classroom
also as a place where she may become
better equipped to care for her patients,
the place where she can explore some of
the difficulties and traumas involved in
this most complex of professions, the
place where learning needs are shared.
Personal qualities and informational
content are twin priorities when plan
ning nursing curricula. An exploration
of the implications of educational policy
directives and current trends in thinking
should guide the decision-making pro
cess. Training should provide opportuni
ties for practising the interpersonal as
well as the cognitive and psychomotor
skills. Integration of theory and practice
is a priority if the student is to link her
practical experiences to her educational
needs. The learning environment is the
phtce where those needs are met.
I seem to be advocating a definite
shift from traditional methods of teach
ing - that is. information giving, teacher
centred styles
to more progressive,
permissive and student centred styles. I
am also aware that autocratic methods
to devalue the status of the learner.
The facade of the expert may be threat
ened by allowing the students to ques
tion. criticise or contradict.
The teacher's “expert", “high status"
roles may tend to demotivate the
learner. They reduce the learner’s aca
dcmic self-concept and undermine her
confidence in what she may like to say.
The lack of confidence which the learner
has in her ability to produce "accept
able" knowledge tends to make her
learning superficial - she tends to repro
duce "appropriate" language, style and
content.
Effective learning has to do with confi
dence as well as intelligence.
Teachers often seem to want to create
dependence in the learner rather than
autonomy.
The new role for the teacher which is
being suggested here is that of a facilita
tor of learning. Such a facilitator would:
provide an environment for students,
in which (here is mutual respect and
support:
allow openness and acceptance in
relationships:
encourage learners to gain insight into
their own strengths and weaknesses;
New role for the students
71
usually take less time to reach meaning
ful levels of cognitive performance.
However, when considering this wider
view of teachtng/leaming
that is. of
developing, acquiring and changing atti
tudes. values, standards, feelings and
emotional conn ol - then student
centred methods are found to be more
elTcctive (Gibbs and Durbridge, and
Gage).
Much of the factual content of the
curriculum can be taught by self instruc
tional methods, hence the interest in set
ting up resource centres in schools of
nursing and the increase of sales of pro
grammed texts produced by us at the
NHS Learning Resources Unit. There
has also been a great demand for infor
mation on the availability of all types of
teaching media. These factors may be
due to the information overload in the
nursing syllabus. They could also point
to the need to free the tutor for more
seminar/tutorial or discussion type ses
sions with her students.
Changes which have their roots
within an organisation and have the
backing and commitment of staff in
volved, are more likely to be brought
about effectively (Taylor and Walton).
Changes which are imposed from with
out may take much longer. Energies
which could be employed in constructive
planning may be dissipated tn all sorts of
resisting behaviours. Teaching staff will
need time to develop new skills and
priority must go to in-service training.
I do not believe this to be the outpour
ing of a naive Utopian theorist: some
schools of nursing are already imple
menting integrated modular training
schemes, in an attempt to provide a
cohesive meaningful training for their
students. Nor do I believe the environ
ment which encourages student directed
study to be one where teachers are unin
volved or opt out. This approach calls
for a deep commitment, a sharing of
concern to meet the educational needs to
tomorrow's nurses.
References
Boydell. Tom (1976). "Experiential learning"
(Manchester Monograph 5). Department of
Adult Education. University of Manchester
Gage. N. L. (1972). Teacher Effectiveness and
Teacher Education Pacific Books.
General Nursing Council Taper on Educational
Policy 1977 79
Gibbs. G.. and Durbridge. N. (1977) Character
isucs of O U. Tutors. Open University Press.
Sculo. C. D. (1978). "Development of a tax
onomy for the nursing process". Journal of Nurs
mg Education. 17, June.
laylor, P H.. and Walton. J. (Eds) (197.1). The
Curriculum: Kcscarch, Innovation and Change.
Ward Lock Educational
Rogers. C. (1976). Freedom to Learn. Allen
Lane
Rogers. J. (1971) ,4duh Learning Open tinner
sity Press
NEXT WEEK: Learning objectives and
the nursing process.
‘Would you tell inc please which way I ought to go Iroin here?"
’ That depends a great deal on where you want to get to." said the cat.
"I don't much care where . .
said Alice.
“ I’hen it doesn't mailer which way you go," said the cat.
". . . so long as I get somewhere." Alice added as an explanation.
“Oh! you're sure to do that," said the cal. "if you only walk long enough."
Lewis Carroll. .4hre tn ll'umleilund
TURS1: educators today are fac
ing the challenge of restruclur
JL
mg the curriculum to meet the
EEC directives and the GNC educa
nonal policy recommendations. It is an
appropriate time to reflect on where we
are. and where we may like to go. in set
ting educational objectives for nursing
/Ml of us have objectives of one kind
or another, serving as an underlying
basis for our actions. Sometimes these
are vague and undefined: "I must do
something to liven up my social life"; at
other limes, we have quite specific things
in mind: "I am going to lose 71b before
my summer holidays.”
Milestones to achievement
Objectives can be our own. or they
can be offered, and sometimes even im
posed upon us. by someone else. What
ever their source, objectives can be
viewed as markers or milestones on the
way to the achievement of some effort,
ambition or accomplishment.
The word objective in Roman times
referred to a pillar which marked some
turning point jn a chariot race. With this
in mind, an objective does not have to be
seen as a final destination marking the
termination of an activity, it can also
refer to markers along the way. turning
points or. as in the case of a microscope
lens, a point marking a maximum con
centration of energy (Davies).
Myths and misconceptions
The publication in 1956 of The Tax
onomy of Educational Objectives. Hand
book I. Cognitive Domain, edited by
Benjamin Bloom, stimulated interest in
the identification, description, classifica
(ion and measurement of educational
goals. The original taxonomy was de
signed as a classification of student
behaviours; the objectives listed, varying
a great deal in their level of specificity,
are expressed in terms of interred mental
processes.
Bloom's taxonomy, coupled with tin
programmed learning movement, led io
a strong behavioural objectives move
ment employing specific highly detailed
I'he author is Unit Director. MIS
Learning Resources Unit. Sheffield
City Polytechnic.
Objectives
Markers
along
the
way
Sheila Marton
Sheila Marson, SRN, RSCN, SCM, RNT, examines
learning objectives and the nursing process, pointing
out that an objective should not be regarded as a final
destination marking the end of an activity.
objectives, the emphasis lying on overt
student performance that is, what the
student would be able lo do as a result
of instruction rather than on what the
teacher did. “While this approach has
many attractive features, the apparent
simplicity can conceal some real
hazards for the curriculum developer"
(I log ben).
The hazards apart, however, the be
havioural objectives movement has led
to unproved practices in education and
training. The attention of teachers, edu
cational developers and designers was
drawn to the fact that many courses and
units of instruction had been planned,
implemented and evaluated, without the
benefit of slated goals. Where goals had
been slated, they were often too vague
or too hrt»ad to give real guidance or
direction.
72
It may be useful here to look at the
features of a behaviourally staled objec
live: what it should contain and what
should be avoided.
Characteristics and classification
Some champions of the behavioural
objectives approach have described the
following objectives
"An objective is an intent communi
cated by a statement of what the learner
is to be like when lie has successfully
completed a learning experience. It is a
description of a pattern of behaviour
(performance) we want the learner lo be
able lo demonstrate” (Mager).
"A statement of an objective is useful to
the extent that it specifies what the
learner must be able to do or perform
when he is demonstrating his mastery of
the ohiectixe" (Mager)
"A satisfactory instructional objective
must describe an observable behaviour
of the learner or a product which is a
consequence of learner
behaviour"
(Popham).
"In addition to the content on which
learner behaviour is to be performed, a
useful instructional objective must state
both the intended observable learner be •
haviour which will result from mstruc
tion and (he relevant conditions under
which it will be performed (Sullivan).
"Behavioural objectives are statements
which describe what students will be
able to do after completing a prescribed
unit of instruction" (Kibler).
An examination of these statements
identifies some of (he main features of
behavioural objectives. First, the focus
lies squarely on the learner, not the
teacher. Second, the importance of stat
ing objectives in terms of what the
learner will be able to do is stressed.
Other considerations emphasised by
Mager include the conditions under
which the behaviour will be observed
and the standards to be achieved.
A typical example offered by Mager
reads: “Given a human skeleton, the
student must be able to correctly iden
tify by labelling at least 40 of the follow
ing hones; there will be no penalty for
guessing” (list of bones included).
Highly specific statements of this kind
abound in the literature on behavioural
objectives.
Not all the proponents of behavioural
objectives insist on such detail, however.
Other workers suggest rather more
generalised statements of differing levels
of specificity, according to the nature of
(he learning task and demands of the
subject matter; in other words, it all
depends.
Krathwohl suggests we need objec
tives at three levels of specificity.
level I general statements of intent
serving as useful guidelines for planning
a course.
Level 2: behavioural objectives derived
from Level I statements to use as cur
ricular building blocks.
Level 3: specific behavioural objectives
for the creation of instructional mater
ials and experiences.
These three levels can be illustrated
by taking an example from the Joint
Board of Clinical Nursing Studies’ Out
line Curriculum in the Nursing of
Venereal Diseases.
Level /. at the end of the course, the
nurse will be skilled in diagnostic tech
niques
Level 2: the nurse will be skilled in (he
use and management of the microscope
and have knowledge of microscopy
techniques.
Level 3: at the end of the unit of instruc
tion. the student will he able to: (a)
define the principle by which an optical
IS
microscope works, identify correctly the
working parts and give a brief descrip
lion of the function of each part, (b)
complete a simple diagram to show ihc
passage of light ravs through the micro
scope and the cifect ol mirror, condenser
slide, immersion oil. objective and eye
piece on the path of light rays; (c) focus
a microscope so that (he image can be
clearly seen without damage to slide or
objective.
Uses and abuses
fhe main argument in support of be
havioural objectives is that they provide
a target for teaching and learning and a
measure of its success. In other words,
they give clearly defined goals for both
student and teacher to work towards,
and enable the quality and efTcctiveness
of instruction to be assessed. Another
argument in their favour is that the
removal of ambiguities from the learning
task allows for a more rational approach
to the selection of an appropriate teach
iThore are pitfalls along
the behavioural objectives
road. Too much attention
to the behavioural aspects
can result in trivial and
irrelevant
or,
at
their
worst, worthless objec
tives. Some of the most
worthwhile behaviours we
require of our students are
the most difficult to de
scribe 3
ing method or media. In other words,
when we know exactly where we are
going we are in a better position to select
the most direct route and an appropriate
means of travel.
As suggested in the first paragraph,
however, thetc arc pitfalls along the be
havioural objectives road. Too much
attention to the behavioural aspects can
result in trivial and irrelevant or, at their
worst, worthless objectives. Some of the
most worthwhile behaviours we require
of our students arr the most difficult to
describe.
A rose by any other name
Another more practical issue experi
enced by teachers is that the writing of
relevant, worthwhile objectives is a very
lime consuming and mentally exhaust
ing exercise, leading many to wonder if
the outcome is worth all the effort. Some
even feel that to specify objectives inter
feres with freedom and creativity in
teaching and learning.
The idea of objectives in nurse educa
lion is not a nc« one in fact, good
73
teachers throughout the years have been
using objectives. I have a vivid reeollcc
tion of a nursing school staff meeting
early in my nurse teaching cateer; the
meeting was called to plan a forth
coming study block. Discussion centred
on the merits and demerits of various
lecturers, films and methods of teaching,
until one experienced teacher, on the
point of retiring, drew us up sharply
with (he comment. We are discussing
everything but what the students will be
able to do at the end of the block."
Now. many years on, the idea of be
havioural objectives is no longer a novel
one. Trainee nurse teachers arc familiar
with, if not experienced in. the writing of
behavioural objectives for the instruc
tion or experience they arc planning for
the learner.
In mv experience, however, objectives
spc -ilicd for nurse education lie at either
end of the extremes. That is. they arc
either loo generalised to be put into op
cration easily or they lie at the lowest
level of Bloom s taxonomy, being con
ccrncd with the recall of factual know
ledge rather than the higher order mental
processes of analysis, synthesis and
problem-solving. Perhaps the next step
is to be able to write and use meaningful
behavioural objectives of a higher order
in the affective and psychomotor as well
as the cognitive domain, to avoid con
ccntrating on one domain to the exclu
sion of the other.
A resume of Bloom
It has been said that Bloom's tax
onomy is the most quoted but the least
used of books in education. If the nurse
teacher can brace herself to peruse more
than the introductory chapters, there is
much to be gained.
Cognitive domain
Bloom's taxonomy of the cognitive
domain deals with knowledge and tin
dcrslanding. It is concerned with pro
cesses within the student's mind involv
ing the recall of facts, concepts and
principles and the application of these to
the solving of a problem.
Bloom describes six levels of cognitive
behaviour which can be arranged in a
hierarchical sequence. These are: know
ledge.
comprehension.
application,
analysis, synthesis and evaluation.
For many years, the teaching t.f nurs
ing has been at the lowest level of
Bloom's taxonomy. The role of the
nurse teacher was to "give them the
facts", the student's role to memorise
and regurgitate these. This was called
learning. We now realise that students
can learn facts on their own.
The nurse teacher's role has dcvel
oped from an imparter of facts to a faci
litator of learning, a guide and counsel
Nursing Mirror. August If' 1'17')
lor It is important, one may even sax
essential, therefore, to write objectives
that involve lnghei order mental pro
cesses than those ol the memorisation
and recall ol tacts, if the musing process
is to lie implemented fully
been developed as fully
(hai hi ilic
cognitive domain
Dorothy Reilly suggests Davies lax
onoiny of psychomotor behaviours is
the most applicable io nut sing, and gives
helpful examples.
Affective domain
Behaviours in the affective domain
are (hose which relate lo the students'
feelings, beliefs, altitudes and value sys
terns While few challenge the concept of
behavioural objectives in the cognitive
domain, there is less agreement among
teachers on the relevancy of setting
objectives in the affective domain. Some
may indeed challenge the right of
teachers to concern themselves with a
student's attitudes and value systems,
equaling it with the Leaching of moral
dogma.
In nurse education, leaching in the
affective domain could be seen as help
mg the trainee determine options and de
velop guidelines for selecting from alter
native courses of action those which w ill
ultimately enrich her relationship with
patients and colleagues.
If we accept this as a desirable aim. it
is essential that affective behaviours for
a particular nursing situation be identi
lied, analysed and operationalised into a
learning situation for the student. The
planning of learning experiences to re
alise affective behavioural objectives is a
very difficult task, however, and one
which has yet to be tackled effectively in
nurse education. The Taxonomy of Edu
cational Objectives. Handbook 1. Affec
live Domain (Krathwohl, Bloom, Masia)
describes (he various levels of affective
behaviours and gives examples of be
havioural objectives for each, many of
which can be applied in nurse education.
Tha three domains
Psychotnoior domain
The psychomotor domain can be
defined as "those behaviours which in
elude muscular action and require
neuromuscular co-ordination’'. Practical
nursing skills do not lie wholly in the one
domain; usually all three are involved
Performing a practical skill such as giv
ing an intramuscular injection involves
cognitive, affective and psychomotor be
haviours. Learning psychomotor skills is
an egocentric process which absorbs the
learner's attention until the final stages
of learning are reached and the skill
becomes an automatic response.
it is important for nurse teachers to
focus on only the psychomotor aspects
of the skill until this final stage is
reached; thereafter, the skill can be
viewed in ns relation to the total pheno
mena of nursing care. I low would the
learner driver react if, the first lime he
look the car onto a main road, the in
structor asked him what the functions of
the gears were? The taxonomy for the
psychomotor domain of learning has not
Although the three domains have
been isolated to demonstrate then nidi
vidual characteristics, it must be remem
bered that human behaviour is a holistic
process. All three types of behaviour
need to be integrated in a compatible
and complementary manner to form
relevant learning experiences. There has
been a tendency over the past few years,
arising out of the knowledge explosion,
to overemphasise the cognitive aspects
of nursing. Learning experiences should
be planned to ensure all three domains
receive appropriate emphasis The tax
6 The behavioural objec
tives movement has led to
improved practices in edu
cation and training. The
attention of teachers, edu
cational developers and
designers was drawn to
the fact that many courses
and units of instruction
had been planned, imple
mented
and
evaluated,
without the benefit of
stated goals 9
onomies, therefore, give a guide to the
selection of meaningful experiences and
suitable evaluation procedures.
Learning to use the process
Jean Heath suggested last week that
to produce "the kind of nurse needed lo
implement -the nursing process will
necessitate changes of thinking in both
teacher and learner". 1 suggest we need
to go back and lake a critical look at
"behavioural objectives".
Some of the arguments raised against
them need to be reconsidered notably
the arguments that; (I) they stifle the
creative process by interfering with (he
freedom lo leach and learn; (2) the need
for precision in (heir specification is
completely at odds with the complexity
of nursing; (3) the time and eiTbri spent
in developing objectives is not just died
bx their effect on the final outcome of a
nurse n aming programme.
To take the first argument, bchax ioui
al objectives can be instrumental in pro
viding a framework xvithin which rele
xant learning experiences and evaluation
methods can be developed Sliucttifc. i!
74
t elex ant and flexible, does not stifle free
dom bm rather enhances it. Note the
chaos that results when structure is
withdrawn from society by strike action.
A slated destination does not mean that
.ill learners anil teachers must follow- the
same route but. rather, the route most
appropriate for (hem.
In response lo the second argument, it
is important lo remember that alterna
live approaches lo the development of
behavioural objectives do exist. The
approach developed by Mager is rele
xant to the development of programmed
instruciion or to lower levels of cognitive
behaviour but inappropriate lo develop
mg the higher level cognitive and affec
live behaviours inherent in applying the
nursing process. Perhaps what we need
is a taxonomy of behavioural objectives
for the nursing process.
The third argument against specifying
behavioural objectives, that it is "loo
time consuming" is invalidated in my
mind. I see the introduction of the nurs
mg process as providing an opportunity
for all those involved in training and
educating nurses to get together lo
explore their own knowledge, experi
ence, values and beliefs about nursing,
leaching and the society in which we
live Behavioural objectives arising out
of these explorations xvill provide the
necessary structure on which to build a
relevant and effective nursing curricu
lum for the future
References
Blouin. B S. (editor). Englehari, M. I) . l urst,
t. J . Hill, W. H„ and Krathwohl. D R (1956).
I'hc lusonomy of Educational Objectives, Hand
book I, Cognitive Domain. Longman Group.
London.
Dave. R II (1976). Psychonutior Levels in De
vetoping and Hunting Behavioural Objectives
Educational Innovators Press, Tuscon, Arizona.
Davies. G. K (1976). Objectives in Curriculum
/)euK>t. McGraw Hill. UK
Hogben. D. (1972). The behavioural objectives
approach: some problems and some dangers."
Journal of Curriculum Studies, no. 4. 42.
Kibler. R. J . Barker. L I... and Miles. D T(I97(J). behavioural Objectives and Instruction.
Allxn and Bacon. Boston
Krathwohl. D. R.. Bloom, B S. and Masia. H B
I 1964). I'he Taxonomy <>t Educational Objec
lives. Handbook I. Affective Dornum Longman
Group. London.
Kraihwohl. D R (1965) "Stating objectives
appropriately for program, lor cuinculum. and
lor instructional materials development." Journal
of Teacher Education. 16, 8 <
Mager. R. F (1962) Preparing instructional
Objectives. Fearon. Palo Alto.
Popham. W. J (1969) Objectives and Instruc
tian zXmerican Educational Research Associ
ation Monograph series on curriculum evalua
ti.in. 3, 1? Rand McNally. Chicago
Reillx. D 1; (1975) Behavioural Obieclwes in
Xursing. EvalualiuH ol Learner tinitinicnl.
Appleton Century Crolts.
Sullivan. IL J (1969). Objectives Evaluation and
improved I.earner Achievement American Edu
cational Research Association. Monogiapll series
ml curriculum evaluation. 3. 65. Rand McNally
NI X I W1I K: Il’s a taxing process.
Its a taxing
nrncsss
Jean Heath, SRN, SCM,
and Sheila Marson, SRN,
RSCN, SCM, RNT,
continue the series with a
discussion of the
educational implications of
the nursing process
philosophy.
C
Imes
■
of the first article in this
series (NM. August 9) centred
’ -Aon learning: the learning cli
JL
mate,
learning to communicate,
and
encouraging nurses to take responsi
bility for their own learning.
When we talk about learning, we are
using the same term to describe a wide
range of different outcomes and pro
cesses. We talk about “learning the six
Sheila Marson (left) and Jean Heath in the Unit library
times table", "learning to tie shoelaces"
and “learning to live again" after
physical or psychological disaster.
It will be clear from this that although
each of these involves learning, the pro
cesses and outcomes are very different.
ASSESSMENT
Interviewing
listening
self awareness
What is learning?
Observation skills
Learning has been defined (Gagne) as
a “change in human disposition or capa
bilily which can be retained and which is
not simply ascribable to the process of
growth"
Gagne goes on to say: "The kind of
change called learning then exhibits
itself as a change in behaviour, and the
inference that learning has taken place is
made by comparing what behaviour was
possible before the individual was placed
in a ‘learning’ situation, and what behav
iour can be demonstrated after the
event. The change may be an increased
capability to perform some kind of skill,
Measurement, recording
Inferring
/
Comparing, identifying
Discriminating
PLANNING
Analysing
Goal setting X.
1
2
3.
4
5
Obiective stating
Prescribing action
Communicating
Learning
Information
Resources
Sheffield City Polytechnic.
Identifying
Hypothesising
(J/Jicer.
Unit.
Figure 1 Nursing skills in the nuising process
75
Reassessing
Judging
Psychomotor skills
Reviewing
Responding
Valuing
Organisation
Cliaracterisation
Sheila Morson is Unit Director, and
Heath,
Interpreting
Taxonomy
of education
m affective domain
IKrathwohl 19641
Priority stating
NIIS
Organisation skills
Communication skills
—Inferring
cognitive (mental), psychomotor (pracli
cal) or social, or a change in affect
ie.
disposition, attitude, interest or value
system. The change must be of more
Jean
IMPLEMENTING
EVALUATING
Defining criteria
Assessing information
Assessing own behaviour
Assessing others’ tiehaviour
Judging
Interpreting
Adapting
Communicating
than momentary |>crmanence
ie. u
must be capable of being ictamed over
some period ol tune. Il must also be dis
linguishable fimn the kind ol change
attributable to physical growth
What is leaching?
if lite aim of teaching is the achieve
meni of some specific end state, what
then is teaching? It has been argued
(Hirst) that (here is no such thing as
teaching without the intention to bring
about learning. leaching, thcrelore. is
the label applied to those activities ol a
person A (the teacher), the intention of
which is to bring about in another per
son B (the learner) the’ achievement of
an end state X (ie. learning). These ac
tivities can include designing a curricu
lum, engaging tn didactic teaching, and
carrying out activities of the non direc
tive variety currently in vogue.
Moans and ends
Il would seem that what we should be
more concerned with is ends rather than
means. Once ends are defined, the
means of achieving them can be tailored
to the personalities of individual learners
and teachers and the organisational
ambience. With the more traditional
task centred approach to nursing, it was
relatively easy to define objectives (ie,
ends).
When one looks at more complex ac
tivities such as those involved in learning
to implement and, what is perhaps more
mi|x>riant, to internalise the values of
(lie nursing process approach, ends are
not so clear cut. Until the nettle is
grasped by both nurse teachers and clin
icians alike that is, until we can define
appropriate and relevant learning objec
tives for both clinical experience and
classroom
the selection of eiTective
learning experiences and appropriate
evaluation tools will be akin to a shot in
the dark. We can argue the merits of
autonomous versus directive learning
systems, block versus modular systems.
ad infinitum. These arguments may be
irrelevant until it has been decided what
leachers in classroom or ward may
wish to be more specific in certain areas
lot example, in the learning or practice
ol certain nursing procedures.
We have also assumed that the slu
dents' learning will be integrated and
that the classroom will offer a connnua
lion and relevant theoretical back up to
the learning experience on the ward.
Implications ol implementation
The examples we have given in this
article represent our view as educational
Are learning objectives specified for the experience available on the ward or
department ?
Do tlie objectives slate what the learner will be able to do and the standard io
be achieved rather than experience available1
Do the objectives reflect the nursing process approach ?
What account has been taken of learners previous experience when planning
objectives for ward experience?
What measures are taken to determine learners' skills and abilities at the
beginning of their span of service on Die ward?
What measures are to be taken to determine whether learners have achieved
objectives specified at end of ward experience?
Are learners given sufficient and frequent information on their progress1
How committed are other trained members of the ward learn to supporting and
encouraging learners?
How is the commitment to supporting and encouraging learners expressed-1
Do any members of the team have special abilities or qualities which can be
utilised to the learners' advantage?
How far are trainees encouraged to give their own ideas, criticisms and
suggestions about nursing care?
Are they involved in decision-making, problem-solving and planning of nursing
care?
How are trainees helped to develop their communication skills; are there any
problems specific to this experience?
Does the ward ambience emphasise total patient care?
Are interpersonal relationships between learners and trained staff open enough
to allow deep positive and negative feelings to be expressed?
What learning materials (eg. books, charts, models, tape slides) are available on
the ward/department ?
Ate the materials up iodate and at a suitable level for learners?
Are they easily accessible to learners?
Is there anything else Dial could be obtained/prepared tu help learners?
Figufa3:Question* Io usk eervice slalf.
Ate objectives clearly defined lot each unit of learning?
Do the objectives meet (he learners , rather than the tutors , needs?
How far have learners been involved in identifying learning needs and objectives?
Do objectives specified reflect the nursing process rather than the medical
model ?
it I* we want to achieve.
The quality of nursing care
In the first article in this series, n was
suggested that a consideration of the
qualities of the nurse was as important
as her knowledge and skills achieve
meni. Last week, in part two. it was sug
gested that a taxonomy of objectives
might be devised around the nursing
process - a taxonomy which would take
into account the aUcctive domain of
nursing behaviours (that is. those con
ccriung feelings, beliefs and values).
I o facilitate this, we oiler an example
ol a nursing process taxonomy. The four
components of the process (Mcl arhine)
arc presented in terms of nursing skills
(figure I). I he luciatchy ol alleciivc be
Mm.';
haviours is shown in (he centre. I Ins we
see as a centra) issue il nurses are to
embrace the philosophy of the nursing
process and not pay lip service to the
m.ichiuei y ol it
In the four tables in this article, we
give an example of how objectives relat
ing to steps in the nursing process will
suggest learning experiences and help to
focus on the appropriate evaluation
technique.
The objectives staled are very broad
and should provide general guidelines.
■t
| ‘I '•I
Are the objectives operational (ie, defined in such a way that their achievement
can be clearly demonstrated) ’
Do the learning experiences planned relate to (he course objectives?
Are die evaluatory tools appropriate for each learning experience (ie. are they
valid and reliable)'1
Are learners encouraged to carry out self- and/or peer evaluation1
How prepared are teachers to allow learners to evaluate their teaching practices?
Do relationships between teachers and learners encourage open
communication?
Aie learners helped to learn to work effectively with others on problem solving
activities?
Are ideas, criticisms and suggestions invited from learners1
Are learners involved in decision-making *
What iesource materials are available tor learners
How well is this integrated into the curriculum?
Are the materials easily accessible ’
Figum 4 Questions to ask tutorial stafl
76
technologists on the problem ol iucor
porating new ideas
such as (he GNt
educational policy and the I FC direc
fives
into a traditional framework of
training. Hie system we have used
should not be seen as fixed and rigid but
rather as a dynamic and continually
evolving process where one is con
tinually reviewing ends and adjusting
means. Whatever conceptual framework
is used as a base for curriculum develop
rnent. it should reflect a total view of the
patient as an individual, as expressed in
Raferences
the nursing process.
No math < how carefully a curriculum
is planned, its success will depend on the
Gagne. Robert M (1970). The ( mull
tions <>/ I,earning (2nd edition). Halt.
Rinehart and Winston
«av it i> implemented A commitment
will he neerled on the part ol service and
teaching siall to its underlying philos
ophy. Wc conclude by suggesting a
basic framework (Figures I and 4) of
questions to ask. lor (hose wishing Io
implement a curriculum based on (he
nursing process O
General Nursing Council (1977)
cational policy statement
I du
Hirst. Paul M (1971). ' What is teach
ing?" Journal of Curriculum Studies.
no. J, 5.
McFarlane. J. (1978). Workshop on
nursing process. Manchester University
Figure 2: A trnmework for clnxxilying objoctivni in th« affective domain (from Trnronomy of Educatinnet objectivet, Krethwoht. Bloom and Musia).
1.0 Receiving (intending)
1 1 Awareness
1.2 Willingness to receive
1 3 Controlled or selected attention
the learner is aware of the existence of a certain stimulus.
attends to it and becomes willing to receive it
attends when others speak
increase in sensitivity to human need
alertness toward human values
2.0 Responding
2.1 Acquiescence in responding
2 2 Willingness to respond
2 3 Satisfaction in response
the learner is cornrnittiiing himself in some degree to the
"hnnamena involved becomes interested in
. wilim'vmss io comply with health regulations
. hnds pleasure in reading
3.0 Valuing
3.1 Acceptance of a value
3.2 Preference for a value
3.3 Commitment (conviction)
implies the learner's commitment to the behaviour which is
guided by the value
assumes responsibility for . . .
. actively participates in . .
4.0 Organisation
4.1 Conceptualisation of a value
4 2 Organisation of a value system
as new values are internalised, these are gradually organised
into a system
. forms judgments about. .
develops a plan for...
5.0 Characterisation by a value or value complex
5.1 Generalised set
5.2 Characterisation
the individual acts consistently in accordance with the values
he has internalised
. develops a code of behaviour
judges terms or issues in a situation in accordance with
ordered value system rather than "emotional wishful thinking''
or fixed dogmatic precepts
Steps in nursing process
1. ASSESSMENT
Information gathering about an
individual pationt. Data
collecting and recording
Interviewing patients
Obseivation of patient
Reading and interpreting
records
- Analysis of information
gathered
-- relevant/irrelevant
- normal/abnormal
-Identifying problem
actual potential
- Identifying strengths
actual potential
- Priority setting
2ft
Objectives
The nurse learner
. identifies factors in the
patient's environment which
influence his ability to adapt to
the limitation imposed by his
illness
... develops an awareness of
the importance of maintaining
effective relationships with her
patients
.. expresses an awareness of
the need to involve the patient
and his family in developing a
plan of care
. . listens to the patient
express his concerns
... deduces relevancies and
inter-relationships of
information gained on
assessment
. interprets information in
terms of scientific theory
concepts and principles
i .. identifies significant
' relationships arnonq
| information gained
Learning experience
Ward
The learner carries out
assessment of patient
according to individual ward
requirements
Discussion with sister/nurse in
charge re findings, difficulties,
possible omissions
- is encouraged to identify all
possible sources of information
- is encouraged to discuss any
communication problems with
child or relative and explore
own reactions to those
difficulties
Classroom
Sociological aspects
child in society
child in the family
Child development
Common medical conditions
Common surgical conditions
and their treatment
Common congenital
abnormalities and their
correction
| Observation skills
I Recording skills
I Communication skills training
I relationships with
I colleagues in care team
| effective listening
effective communication
the role and the person
altitudes valuesand
; assumptions
77
I Evaluation techniques
Ward
Nurse audit/criteria checklist.
eg student encourages patient
to express concerns about
impending surgery
Criteria for evaluation
- identification of patient
verbal and non-verbal cues
- relevance of implications for
nursing actions to cues
exhibited in the
communications
Observations of student in care
planning meetings
Classroom
Written work
Discussions and interviews
Role play
Interview tape playback on
video or audio cassette.
Ntirsirip Minor. Aitglisl
’ I')?')
The nurse learner
Ward
contrasts the needs ol a
Iearnei is encouraged to
pai ticipate actively in the
patient in a temporary acute
illness with those of a patient
formulation ol paediatric care
plans
with a firogressive illness
assumes responsibility lor
involving patients and their
Classroom
Identification ol the needs ol a
families in decisions of care
that affect their lives
Child linked Io activities of daily
predicts the consequences
living (Roper. N )
Identification of the needs ol
of certain nursing actions from
mother or other significant
the information collected
‘',i’,'‘'’p
’*
‘
lediatnc
patient
makes judgments regarding 1 relatives of a pa»
Practice in planning lor care
various approaches to nursing
horn given assessment forms
care
Discussions with tutor and
. selects nursing measures
peers about
calculated to be most effective
I
possible approaches to care
in meeting nursing objectives
irnplications/outcomes for
communicates plan of care 1
| different approaches
to others in the care team
problem stating
priority setting
2. Pl ANNING noising cure
Selling objectives
short-term
long term
Deter mining <illi:i i i.itivc
noising ac hi iris and thuii
coiiseguerices
Selecting appro)ipriate action
Seiling priorities:s ol action
decided upon
Formation of care plan (with
team if appropriate)
|I 1 he nurse learner
3. IMPlfcMENl AVION
Preparation
sell
environment
patient
Action
inform
leacli/support/counsel/refer
provide care
- comfort measures
maintenance
diagnostic
prevention
Record and repoit
demonstrates her ability to
I maintain good inter-personal
I relations with her patient in
| providing care
;
values and protects the
i patient s right to privacy
performs technical skills
; competently and safely
works with patient and
others to provide continuity of
care
records significant
information accurately
. . instructs the patient and his
family in relation to identified
learning needs
The nurse learner
4 EVALUATION
. validates tier own behaviour
a. Evaluate outcomes of
in relation to her nursing
nursing action taken
objectives for a particular
- collect information related to
group of patients
nursing objectives set - record
. provides rationale for
compare this information
with expected results
various outcomes
. uses defined criteria to
- judge the degree to which
these objectives have been met measure the results of care
b. Evaluation
•' steps
iluation of‘ the
of• the given
.... Use
11 . the
a... information
i
_ able to discuss and
process.
assess each step of the nursing
gained to evaluate the steps of
process in relation to care
the nursing process to
given
determine further action eg:
.. adapts or modifies plan and
how good is the system of data
behaviour as indicated in the
collection? Does the nursing
evaluation
history allow information to be
collected on physical,
psychological and social
aspects of need?
are patient problems and goals
clearly stated?
does the plan of care identify
nursing action to be taken
frequency and who is
responsible?
is there an effective
evalualoty system ’
Modify plans as necessaiy
Repot (/lecmd
Vli'IlM
I'.'
t-
Ward
The learner is encouraged to
participate in carrying out
nursing care plans (according
to level of experience),
recording and reporting
procedures
Classroom
Demonstration and practice ol
various skills necessary for the
sate practice of nursing care
Communication skills naining
in relation to interpretation of
patient s verbal and non-verbal
cues during nursing procedures
discussion/roleplay
Ward
The learner participates in
evaluating care given
Reviews and evaluates tlie
nursing process in relation to
the total care of a patient or
group of patients
Ward
Obseivatiun ol learner during
planning session
relevant contribution
ability to see pnonty
ability to state possible
outcomes ol care planned
. Classroom
, Written care plans discussions
with tutor and peers
I Problem solving exercises
i Simulation games
Ward
Criteria check lists tor
observers eg student explains
a procedure to a child
- explanation precedes
procedure
explanation is in language
tfte Cltild can understand
- explanation is accurate
the child is encouraged to ask
questions and express concern
questions ate answered
accurately and sensitively
Classroom
Critical incident technique - a
critical incident is one which
"makes a significant difference
in the outcome of an activity
(Fivars and Gaswell) - eg
student explains a procedure to
a child
1 Identify
a. learner behaviours which
assisted the child to
understand and accept
explanations given
b learner behaviours which
interfeied with effectiveness ol
the communication rating
Ward
Ability to adapt care plan as a
result of evaluation findings, in
consultation if necessary
Recordings of evaluation
findings and reasons lot
non attainment ol set
objectives
Classroom
Interpretation and evaluation
of patient observations and
recordings
Criteria for judging the results
of different nursing action
Reviewing and evaluating
steps of the nursing process
Nursing care studies - a
problem solving activity wfiere
students can evaluate ttie
steps of the process related to
individual patient
78
Classroom
Nurses notes on caie plan
evaluated to assess learner
practice competency
In discussion, learner able to
explore critically own
behaviours at different points
in tlie process
L earner able to verbalise about
tier own learning cognitive,
psychomotor or affective and
give examples
INTENTION AND PRACTICE IN NURSING EDUCATION
A way of looking at the relationship between the
stated aims and objectives of a nursing curriculum
and how the teacher implements these in practice.
Tutors in schools of nursing throughout the country
have, over the last few years, been involved with
curriculum reform. Many working groups have been
set up to re-design nursing programmes in order to
reflect a nursing model which focuses more on the
needs of the individual than on symptoms, diseases
and treatments, which presents a holistic view of
people and their needs rather than a fragmented
topic approach. There has also been a shift in
climate in the classroom from a 'teacher-centred’
approach to one which is more participative and
activity-based. But . . . has there been as
much change as you anticipated or planned for?
It might now be an appropriate time to review the
work done and attempt to assess how the intentions
of the curriculum design relate to the implementa
tion of that design in practice.
One method for examining the curriculum in this
way is to draw up a profile (F.E.C.R.D.U.
publication 1980, from which this article has been
adapted) which will reflect its main character
istics and relate these to the kinds of learning
activity which take place in the classroom. When
writing aims, objectives and planning strategies
for learning it was necessary to distinguish
between items which were primarily to do with
knowing, to do with doing and to do with feeling.
We may also be concerned with pfLOdllCLt
i.e.
concerned to inform students about i.e. giving
information and facts, and p^oce.44
i.e.
79
helping students to learn how to inform them
selves, a concern with continuing development.
The contents of a product or process-centred
course may be similar - the aims will be different
and the methods will be different. A process
approach is not necessarily superior to a product
approach. There are many facts and basic
competencies which are necessary to the mastery
of most skills, and in some situations where
resources are limited it may be more appropriate
to take a product approach.
The qualified nurse hopefully exhibits a wide
range of knowledge, skills and attributes, and
the course of study which enables her to practice
should reflect a broad balance of approaches.
There can, however, be a miss-match between our
intentions when planning and what happens in
practice. In order to look at this in some detail
it is necessary to consider the different approaches
to teaching and learning which may have been
adopted and it may also be of interest to think
about the possible advantages and disadvantages of
each approach.
1.
A compe.Ze.nct/ bcucd appAoac/t - the accent is
on the competent performer and the aims are
derived from the skilled nurse in the
clinical situation.
The risks involved in this approach may be
that:being able to perform a skill does not
necessarily ensure understanding
many items may be labelled simply as
skills which are much more complex
the student will not be able to transfer
knowledge easily
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skill requirements change and need
regular updating.
The possible advantages are that:-
-
it may be attractive to course
participants
there is possibility of quick results
and success
personal development and confidence
can follow acquisition of demonstrable
skills
relevance is easily demonstrated
in theory - is easy to assess both by
learners and tutors
an active job related approach suits
most learners.
3.
An
btued app/toach - this assumes
that ’knowing about’ and ’knowing what’ is
sufficient for nursing development. The aims
of this approach are derived from a
situational analysis of the service needs and
the academic subjects involved.
The possible risks attached to this may be:-
that knowledge may be accrued to enable
the student to pass an exam and be of
temporary significance
that the students will be given a narrow
view of learning and their role in it.
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The possible advantages are that;the content to be taught is easily
avallable.
this method is well established
a factual background is essential for
most kinds of learning
it is relatively easy to test the
learner’s knowledge.
3.
A
ajop/toach. This approach is
concerned with the development of specified
attitudes, values and attributes. Its aims
are derived from assumed requirements of the
working environment, from the members of the
care team, from patients and their relatives
and friends. It is concerned with the develop
ment of responsible attitudes to their work,to
the development of initiative, co-operation
and reliability.
Risks
results may be difficult to measure
the student’s peer group may have more
influence on adopted attitudes than the
teacher.
Potential advantages
the student is often described in terms
of attitudes in both classroom and ward
e.g. well motivated, shows initiative, .a
willing worker, cheerful disposition or
sullen, unco-operative
82
this approach recognises the importance
of the ’affective dimension’
if schools of nursing are to prepare
nurses to work in a team, to value the
needs of their patients, to co-operate,
communicate and co-ordinate, then there
is a case for considering this approach.
These three approaches tend to be product
orientated, whilst the following three may be
labelled ’process’.
An
app/ioac/i. The aims here are
also derived from a situational analysis but
the concern is directed to the future needs
and activities of the learner. The main
characteristics of this approach are openended learner activities rather than clearly
defined objectives. The learner is encouraged
to make his own individual response to a
learning experience.
The risks of this may be that:the activities, being unstructured, may
omit some desirable objectives
the learner may wish to have more
supportive direction from the tutor
learning is difficult to assess.
The potential advantages are that the students
hdve an opportunity to work on their
strengths and develop their potential
as individuals
may become more involved and motivated
as it is unlike traditional classroom
learning.
83
5.
A
app^oack. The general aims of
this approach are to encourage the student
to go beyond the information given, to develop
abilities which will enable him to adapt to
change, to ’transfer’ knowledge in different
situations, to make relationships and to
develop frameworks for dealing with novel
situations. These aims may be derived from
the work situation - of what appears to ’work1
in given situations, from logical problem
solving frameworks e.g. nursing process, from
research findings and from educational
principles.
The risks which may be involved in this approach
are:the students and teachers may feel
uncomfortable with their unconventional
roles associated with this type of
approach
it may be difficult in the short term
to demonstrate relevance to students
unrealistic demands may be made on students
to think and communicate at an abstract
level
it may neglect the area of ’feelings’,
’emotions’ and psychomotor skills
activities can be teacher dominated
and ignore individual student needs.
Potential advantages
a critical understanding of concepts
is encouraged
skills gained are ongoing and useful
in both personal and professional life
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gives status to group and individual
experiences and hopefully improves
learner’s self concept.
6.
A
app/ioach. This approach
encourages reflection on a personal level and
between people and groups. Its aims are to:develop the individuals
understanding and control of his or her
own behaviour
understanding of and interest in the
feelings of others
ability to distinguish between emotional
and cognitive elements in an interation.
The possible risks associated with this
approach are:-
it may appear intrusive to some students
by asking for their involvment at a
personal level
it may demand sophisticated communication
skills which some learners may have
difficulty with
it can descend into mere ’chat’
results may be difficult to measure
the group may become ’exclusive’ and
inward looking.
The potential advantages
the climate for learning enables students
to express feelings
85
motivation can be improved when working
with the students interest and experiences
the student is helped to sort out his own
learning needs and* hopefully will be
committed to the achievement of
objectives set
the student is encouraged to be sensitive to
needs, attitudes and reactions of others.
These six approaches or models serve to analyse
the complex ways you may have planned and imple
mented your course. It is most unlikely that any
one plan would be purely ’information giving’ or
’reflective’ in character, but a course plan may
suggest certain leanings or tendencies to one or
other of the approaches suggested.
A profile can be drawn of your course using these
models as measuring tools.
1
1.
3.
5.
2
6
3
2,
4.
6.
Competency
Socialization
Reflective
5
I
6
Information based
Experiential
Counselling
The heights of the individual models in the profile
reflecting the main characteristics of your course
86
In order to draw a profile of your course, it is
necessary to have a copy of the aims and
objectives, a detailed timetable and the tutor
or tutors who have been involved with the students.
You will need to know - what the students are
learning
- how they are learning
- why they are learning and
- how much time is spent on
it.
First profile your intentions - using the written
aims and objectives for the course, discuss with
the tutor, who will be responsible for each
session on the timetable, what emphasis he intends
to give to which objectives, what learning
strategies he might use related to the needs of
that particular group of learners, Then try to
decide which of the approaches listed best ’fits’
your intentions. It is likely that in any one
session more than one approach will be used, but
it may be possible to estimate roughly. For
example, you may estimate that in Session I on
Monday morning you will put down one point for
Information based, whilst on Session 4 on
Thursday afternoon you may decide the weighting
might be
.5
.25
<>25
Competency
Experiential
Counselling . .
and so on.
The numbers of references to each model is added
up and a profile drawn. This might be done at
the beginning of a block or the beginning of a
week.
After a block or week is over go through the
exercise again with the timetable and the group
of tutors, deciding what actually took place.
Draw another profile and compare with the first.
87
The relationship between intention and practice
will be revealed in the lack of congruence between
the profiles.
This way of looking at a course may also be applied
to a single teaching session and at a personal level0
It is a very useful exercise to consider what we
are doing in this way, whether or not we draw up
actual profiles. Whether or not you use this
method to consider the design and implementation of
courses, the process of discussing these approaches
in curriculum planning groups would, I feel, be a
very productive exercise.
This has been adapted from the work done by the
study group which produced the document
’’Developing Social and Life Skills”*
Strategies for tutors
*
(January 1980)
Produced by the Further Education Curriculum
Review and Development Unit,
Elizabeth House, 39 York Road, London. SEI 7PH
This article has been submitted to Nurse Education
Today for consideration re publication.
Jean Heath
88
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