New sensation

First of all I have to clarify that I´m alright, I´m actually fine. And with that statement I also would like to add a new sudden feeling of loneliness. One year ago I participated in the ONL161 together with Nour, Marc, Åsa, Jennifer and Alastair. Some weeks the struggle was real, especially when it came to find time for the studies. When completing the course I felt like I was on top of the world. I had a feeling of achievement, that I had accomplished something. Last term I was a co-facilitator in the ONL162. This term I am… nothing…

I´m the only one at my department that have participated in the ONL course. To be honest, I have a lack of companions and friendlessness at my department. No one to share the experience of ONL with. In order to take away this feeling, I guess I have a need for new strategies to keep in touch with my personal learning network. As a first step I have decided to be an open learner in the ONL171!

Photo: Loneliness by Paul (CC BY-NC-ND 2.0)

Learning by doing

Is it Dewey who coined the phrase “Learning by doing”?

Dewey claims that there is a relationship between knowledge and active inquiry. He also advocated that action, reflection, emotion and theory is prerequisite for continues life-long learning. The teachers role is to facilitate learning by assisting creation of a cooperative learning exercise. The teachers leadership includes e.g. being aware of past experiences, needs and capacities. To be prepared and have the ability to suggest further learning activities based on the class experiences and by this achieve continued growth (Jarvis, 2010).

I found a quote about learning and doing on the internet, from the book “The Cardturner: A novel about a king, a queen and a joker” written by Louis Sachar. It goes like this:

“I hope I remember everything,” said Toni.
“You won’t,” said Trapp. “That’s how you learn. But after you make the same mistake one, or two, or five times, you’ll eventually get it. And then you’ll make new mistakes.”  

I would like to use these insights in my work as a teacher with nursing students. To know and “feel” their needs and to let them fail, and fail again and just encourage them to keep on trying until they get it right. The diversity of different students and their needs are just as big as they are numbered. I believe that diversity is so much more that cultural and ethnically differences. We are all different human beings with different experiences and my job as a teacher is to greet these differences and to facilitate their learning experiences. Some are introvert and maybe they need the courage to speak up, while the opposite to this is them who often say what they think and sometimes in the need of listening. As a teacher I have to pay attention to this diversities so that I can facilitate the learning experience in a correct way.

Chemo_treatment_by_Jenny_Mealing_CCBY_SA_2.0
Chemo treatment by Jenny Mealing (CC BY-SA 2.0)

One concrete example of how I try to work with facilitation and diversity is when I see my nursing students at our clinical training center. In the introduction, I usually start out with asking them of their experiences of administer and handle central venous catheters. You could say that I use this as a baseline for the rest of the class. As often as I can, without being to excessive, I connect and refer back to what they told me. I try to ask questions like, -What if this…? and -What if that…? to students that I have identified in need for it. It has not always been a delightful and easy way to go cause some of them have had tough experiences of those damn catheters. Often relatives in connection with cancer treatment (some alive and some dead). Even themselves who sometimes have been through the cancer treatment – and yes, we have had tears and both physically and mentally reactions but in the end I am confident in my decision to use the students own experiences since I can see that it enhances their motivation to learn.

I strive to be student-centered and one key to that is to motivate. In 2013 The Swedish Federation of Student (not sure of the correct translation) released a report (SFS, 2013). When it came out it got lots of attention and still… we really need to work with these issues. The report argued for the lack of pedagogical and teaching skills of Swedish teacher in higher education. One thing to make it more student-centered is, as I mentioned, to motivate the students while facilitating a learning activity. The students are also eager, if motivated, and requesting activity. I take along this thought and will try to design some student-centered learning activities with hands-on training.

OM152A_Centrala_infarter_Design_HT16

I am, obviously not a graphic designer but I have tried to do a simple sketch of how the workflow of the training cessions are supposed to look like. We have a common introduction and then I divide the students into two smaller groups. One group will work with wound dressing and the other one with injections. After a coffee break, fika as we say in Swedish, the groups are swapping subject to the other. You can´t have too many fika so we go for that one more time and after that we have a common discussion around cases. At the end of the session we summarize. When they are training wound dressing and injections the students are doing it hands-on. In our training center we have dolls for simulation. The students are prepared theoretical by flipped classroom pedagogy and they will also get a film of how the procedure can be done. The task they are supposed to achieve is to train the procedure. Meanwhile a peer is observing using a checklist on the correct procedure, ready to give feedback when finished. So the students are active both by doing and observing. The students will be like critical friends to one another. I cross my fingers that this will work out!

References
Jarvis P (2010) Adult education and lifelong learning. Theory and practice. 4th edition. New York, Routledge.

SFS (2013) Studenternas läranade i centrum. Stockholm (In Swedish)

Photo: Aniversário do Henrique by Tony Cavalcanti (CC BY-NC-ND 2.0)

Diversity

Earlier today at the course “Academic teaching” (which I participate) we were discussion diversity. The learning outcome for me regarding to this topic is:

“Develop different strategies for equal treatment in the meeting with students / participants in heterogeneous groups.”

So, I´ve been thinking of how to embed this in my teaching to nursing students. The topic I teach is about how to administer and handle central venous catheters. One of the learning outcomes is that the students are expected to reflect over risks and how to avoid them.

The university I work in has a strategic platform (Strategy 2020) and Malmö University wants to base its work on four core values; diversity, creativity, quality and commitment to the community. I came up with the idea of using cases to reflect diversity.

In Sweden (were I live and work) we of course have a law for higher education (SFS 1992:1434). For instance, the students are expected to develop their ability to critical thinking and problem solving.

Lynn (1999) writes about the differences between case teaching and research cases. Lynn argues that when teachers use cases from research as an example or illustration the whole idea of case as a method fails thus the thinking has already been done and the conclusion is already made. The research case is more like a lecture where there is “a true” solution to the problem. Therefor, when using case as a method for develop skills in critical thinking the cases have to contain questions to raise. There should be no right answer and the students should be exposed to different problems, issues and choices. Lynn means that the students are supposed to come up with a solution and proposed action regarding to the present dilemma to succeed and develop their critical thinking.

When writing the cases I have to keep this in mind! I don´t want them to have only one right answer. Back to diversity. I will use name, age and gender as a base and they will all represent a diversity of people. Each case will have a picture of the “patient” and I will choose the pictures carefully so that they shows my intended diversity. I will give you one example of a case.

Muslim woman
Photo: Muslim woman by Peter Dahlgren (CC BY-NC 2.0)

Aisha, a female patient, is treated with total parenteral nutrition (TPN). She has a central venous catheters on her neck (it´s like been given “food” straight in to your blood). Aisha is wearing veil. The veil is “hiding” her central venous catheter so you can´t see the venous access or it´s connections.
-What should you, as a nurse, do?

It is very important to be able to observe the venous access and it´s connections on a daily bases. When having a ongoing infusion (TPN) it´s even more required.

I can think of some different paths to go in the discussion. The students can choose to talk about the ethic part of wearing a veil (the patients religious need vs. patients safety need). I will try to provoke the students a bit if they “chicken out” on the dilemma and I want them to give me an answer of how they think and why. I would also like them to talk about hygiene. The right answer is that the veil has to be change every day… but how will they make this happen? As I see it, they can choose different solutions to the problems.

I’m eager to try this out and I think (and hope) that we can talk to each other and have really constructive discussions of how to solve the different dilemmas. I am aware of that this is an example of how to work with diversity in teaching material. A further challenge would be to describe and have a well founded intention to work with diversity in the group of students, but that´s another blog post.

References
Lynn, L (1999). Teaching and learning with cases. A guidebook. Seven bridges press, New York.

SFS 1992:1434 (2016) Högskolelagen. Utbildningsdepartementet, Stockholm. (In Swedish)

Strategy 2020 (2016) Strategic Platform. Malmö University.

Photo: Diversity by Meena Kadri (CC BY-NC-ND 2.0)