Teaching and Learning in Nursing

In general, education mirrors philosophy. Philosophy is the theoretical foundation of education, whereas education is the practical application of philosophy. In short, education and philosophy are interdependent. Similarly, education also consists of two essential interdependent operations, teaching and learning, with the primary goal of producing mutually desired behavior changes in both the teacher and the learner. While teaching is an interactive process that facilitates student learning, learning is a life-long process involving an observable behavior change that can occur due to exposure to environmental stimuli (Bastable, 2003). Whether an individual is learning to teach or teaching to learn, a complicated relationship exists between teaching and learning. For example, a progressive teaching-learning relationship is when the teacher learns from the student just as the student learns from the teacher. However, the relationships between students and teachers can be damaged if what the teachers teach does not match what the students experience. Thus, the right education, which reflects the core values of an educational enterprise, should refine teachers and meet the needs of learners. Also, the philosophical ideals of an academic enterprise should be evident in the design, implementation, and evaluation of its prescribed curriculum (Billings & Halstead, 2016).

Philosophies of Teaching and Learning

The process of teaching and learning does not occur in isolation. This systematic process must take place in a conducive environment to achieve a positive outcome. Desirable outcomes are attainable when the learning environment is grounded in philosophical underpinnings. Philosophy is deeply rooted in values, and educational philosophies bring to light what is involved in the dynamic teaching-learning relationship as well as what education truly means (Bonnel et al., 2019; Billings & Halstead, 2016). For example, worldview philosophies, such as naturalism, realism, and pragmatism, have not only reformed education in general but also explicitly shaped my learning experience over the years.   

Naturalism

As an educational philosophy, naturalism promotes nature as the only influence on learning. Proponents of naturalism, such as Jean Rousseau and Rabindranath Tagore, suggested that nature is the best learning environment and teacher for the child. Naturalism advocates that students should be allowed to be involved in self-education, which is the training of sense organs through self-expression, experience, and observation in a natural environment, with teachers as facilitators (Khasawneh et al., 2016). For example, in undergraduate nursing school, the curriculum was based on exposing students to nursing theories and clinical practice. The clinical aspect placed students in the hospital, the best natural environment for practicing clinical skills such as Foley catheter insertion and nasogastric tube placement. Also, the simulation lab, which mimics the natural environment, provided students with the opportunity to learn different nursing skills with virtual patient technology.

Similarly, in my high school, curricular activities, such as intramural sports, field trips, and conducting experiments in the lab, fostered a positive environment that stimulated learning. As an academic philosophy, naturalism has boosted self-confidence, critical thinking, and technology acquisition. Providing patient care as a nursing student, for instance, allowed me to observe and perform nursing tasks, identify problems, make informed clinical decisions, evaluate interventions, and use computers to document the care provided.  

Realism

Unlike naturalism, realism upholds that experience is the best teacher. Realists like Plato and Aristotle propagated that the physical world is the actual reality and exists independent of the mind, and natural laws rather than the supernatural govern the world. As such, education aims to prepare students to develop their senses and master the material world through inquiry and observation (Lamichkane, 2018). For example, learning the laws of physics and chemistry in high school helped me understand my physical environment, which stimulated my interest to learn more about the transformation and conservation of energy, mainly how to keep the house warm in the rainy season. Also, mastering these laws bolstered my confidence, improved my critical thinking, and heightened my desire to track the weather using the weather app. 

Pragmatism  

For the pragmatists like John Dewey and James Ross, knowledge comes from action – learning by doing. Pragmatism underscores actions and experimentations, which involve learning by experience. For instance, experiential learning with virtual simulation technology allowed me to make mistakes, learn from the pitfalls, and develop good clinical judgment. 

Overall, my past learning experiences have significantly influenced my educational philosophy. My early childhood education was rigid and teacher-centered; however, learning in a nonthreatening environment has been the best experience thus far. In my view, education should emphasize teacher-led, student-centered experiential learning.    

Theories of Teaching and Learning

Just as nursing theories guide evidence-based practices, learning theories direct the best teaching and learning practices. In connection to educational activities, theoretical views provide an overarching framework for teaching activities and help educators understand teaching endeavors meaningfully.

In general, practice generates questions, and more questions call for research and the formulation of theories. Well-defined theories inform research and improve practice. The development of exciting educational frameworks, such as behaviorism and situated learning, has significantly transformed teaching and learning by providing the groundwork for most nursing academic syllabi (Bonnel et al., 2019; Walker & Avant, 2019).

On the one hand, behavioral learning theory is teacher-centered. It focuses on manipulating the consequences of learner behavior to achieve desirable behavior based on the premise that all behaviors are learned. Further, faculty facilitates learning by designing a suitable environment and offering positive reinforcement through continuous feedback while the student tries to achieve the expected behavior. Also, published literature explains that behavior change can occur through observation; however, behavior change can equally occur through deliberate or incidental observation. Besides, there is no clear-cut distinction between conditions involving reinforcement and no consequences (Bonnel et al., 2019; Mukhalalati & Taylor, 2019; Wittmann-Price et al., 2017; Kay & Kibble, 2016; Billings & Halstead, 2016; Fryling et al., 2011).

This theory is beneficial to student learning in the clinical areas. For example, (1) Students can acquire skills by observing nurses, (2) teachers can quickly evaluate students, and (3) Instructors can intervene to prevent harm to patients, whereas the weaknesses of behaviorism in practice settings include: (1) Observation is the only way of knowing, (2) only behaviors furnished in the learning outcomes are encouraged, (3) academic performance is based solely on observable actions.

When applied in classrooms, the following merits are achieved: (1) Students learn by observing fellow students (peer model), (2) teachers promote good behaviors, and (3) students are evaluated based on positive actions, whereas the limitations of behaviorism in traditional classrooms include: (1) Observation is the only way of learning acknowledged, (2) it is not learner-centered, (3) method of evaluation does not support critical thinking and self-reflection (Bonnel et al., 2019; Wittmann-Price et al., 2017; Billings & Halstead, 2016).

In the same vein, distance learning advantages include (1) Learning with technologies such as Zoom and Shadow Health, (2) using online applications to provide immediate feedback, and (3) establishing learning outcomes to guide expected behaviors; while disadvantages are: (1) simulation-based learning offers limited opportunities for observation, (2) all software applications do not have feedback features, and (3) expected behaviors are limited by learning outcomes (Bonnel et al., 2019; Wittmann-Price et al., 2017; Billings & Halstead, 2016).

On the other hand, previous literature suggests that situated learning theory is reality-based and supports learning in the appropriate context or natural environment of daily practice. It promotes interaction among learners as well as between learners and the environment. Learners are generally immersed in a distinct community of practice, which embodies desirable values and behaviors. For example, engineering students should naturally learn in a workshop setting, while nursing students should practice in clinical settings. Put differently, the introduction of the clinical setting into the academic background so that students can learn in an environment similar to where to they will eventually practice. The primary premise is that creating clinical scenarios provides opportunities for students to develop valuable clinical practice skills. Faculty develop learning activities like case studies and simulations to stimulate learning, whereas students learn the practical applications of theoretical concepts (Bonnel et al., 2019; O’Brien & Battista, 2019; Besar, 2018; Wittmann-Price et al., 2017; Billings & Halstead, 2016; Cantillon et al., 2016).  

Situated learning is highly suitable for clinical sites. For instance, (1) Learners are strategically placed in realistic settings to valuable skills, (2) promotes interaction between the learner and the environment, and (3) it promotes group activities; whereas the weaknesses of this theory in authentic settings include: (1) It is founded on the premise that context is specific and rigid, (2) time is a constraint in meeting outcomes, (3) it is limited by a certain of information students must know before obtaining clearance into the clinical site (Bonnel et al., 2019; O’Brien & Battista, 2019; Besar, 2018; Wittmann-Price et al., 2017; Billings & Halstead, 2016; Cantillon et al., 2016).

When applied in classrooms, the following merits are achieved: (1) It encourages role-playing, (2) it fosters scenario-based learning to mimic the actual environment, and (3) it promotes the application of learner’s previous knowledge to solve problems, whereas the shortcomings include: (1) Role-playing cannot replace the authentic setting, (2) the creations of scenarios is abstract and may not be suitable for elementary education, (3) Students may be denied access if the minimum clearance is not met (Bonnel et al., 2019; O’Brien & Battista, 2019; Besar, 2018; Wittmann-Price et al., 2017; Billings & Halstead, 2016; Cantillon et al., 2016). 

Subsequently, virtual learning potential advantages are: (1) Group learning can be enhanced with games and quizzes, (2) it allows the integration of social interactions through blackboard discussions, and (3) a network of communities can be established virtually while the demerits include: (1) It may be difficult to have every learner participate at the same time, (2) virtual interactions may not be appropriate for elementary education, and (3) virtual practice community is not ideal for professions like nursing and engineering (Bonnel et al., 2019; O’Brien & Battista, 2019; Besar, 2018; Wittmann-Price et al., 2017; Billings & Halstead, 2016; Cantillon et al., 2016). 

Both theories promote student learning, support teaching with technologies, and inform learning science. Also, both views represent knowledge integral to educational experiences, particularly in clinical practice (Bonnel et al., 2019; O’Brien & Battista, 2019; Wittmann-Price et al., 2017).  

Conclusion

            Philosophy and education are like energy; the former is potential energy, while the latter is kinetic. Philosophy is the theory of education, whereas education is the practice of philosophy. Consequently, an integral relationship exists between philosophy and education, theory and practice, and teaching and learning. For example, philosophical views uphold the conceptual frameworks of nursing education, as demonstrated in teaching and professional practices. The deliberate application of theories to explain, guide, predict, and justify actions is the distinctive hallmark of any profession. Well-developed ideas help nurse educators uniquely understand teaching and learning and improve practice. However, teaching and learning theories alone do not suffice. The concurrent use of technology and motivational models with appropriate content can buttress these learning principles, enhance the teaching process, and improve learning among nursing students (Bonnel et al., 2019; Walker & Avant, 2019). Also, healthcare is rapidly changing with advancements such as discovering emerging infectious diseases and vaccines, technological breakthroughs, and information explosion. Therefore, proper education will prepare nurses for these changing trends by providing the necessary tools, skills, and knowledge to remain relevant in a fast-changing world. 

 

References

Abu-Qamar, M. Z., Vafeas, C., Ewens, B., Ghosh, M., & Sundin, D. (2020). Postgraduate nurse education and the implications for nurse and patient outcomes: A systematic review. Nurse Education Today92(1), 1-12. https://doi.org/10.1016/j.nedt.2020.104489

Bastable, S.B. (2003). Nurse as educator: Principles of teaching and learning for nursing practice (2nd ed.). Jones and Bartlett.

Besar, P. H. S. N. P. (2018). Situated learning theory: The key to effective classroom teaching? HONAI: International Journal for Educational, Social, Political & Cultural Studies, 1(1), 49-60. https://www.journals.mindamas.com/index.php/honai

Billings, D.M., & Halstead, J.A. (2016). Teaching in nursing: A guide for faculty (5th ed.). Elsevier.

Bonnel, W.E., Smith, K.V., & Hober, C.L. (2019). Teaching with technologies in nursing and the health professions: Strategies for engagement, quality, and safety (2nd ed.). Springer.

Cantillon, P., D’Eath, M., De Grave, W., & Dornan, T. (2016). How do clinicians become teachers? A communities of practice perspective. Advances in Health Sciences Education, 21(5), 991–1008. https://doi.org/10.1007/s10459-016-9674-9

Fryling, M. J., Johnston, C., & Hayes, L. J. (2011). Understanding observational learning: An interbehavioral approach. The Analysis of Verbal Behavior27(1), 191-203. https://doi.org/10.1007/bf03393102

Kay, D., & Kibble, J. (2016). Learning theories 101: Application to everyday teaching and scholarship. Advances in Physiology Education40(1), 17-25. https://doi.org/10.1152/advan.00132.2015

Khasawneh, O., Khaled, A., & Momani, M. A. (2016). The implications of naturalism as an educational philosophy in Jordan from the perspectives of childhood education teachers. Journal of Education and Practice, 7(11), 45-54. https://files.eric.ed.gov/fulltext/EJ1099618.pdf

Lamichkane, C.D. (2018). Understanding the education philosophy and its implications. NCC Journal, 3(1), 24-29. https://doi.org/10.3126/nccj.v3i1.20245

Mukhalalati, B. A., & Taylor, A. (2019). Adult learning theories in context: A quick guide for healthcare professional educators. Journal of Medical Education and Curricular Development6(1), 1-10. https://doi.org/10.1177/2382120519840332

O’Brien, B. C., & Battista, A. (2019). Situated learning theory in health professions education research: A scoping review. Advances in Health Sciences Education25(2), 483-509. https://doi.org/10.1007/s10459-019-09900-w

Walker, L.O., & Avant, K.C. (2019). Strategies for theory construction in nursing. Pearson.

Wittmann-Price, R.A., Godshall, M., & Wilson, L. (2017). Certified nurse educator review manual (3rd ed.). Springer.

Back to blog

Leave a comment