A Concept-Based Approach to Learning

Objectives Define concept-based learning Discuss ways that conceptual-based educational approaches promote learning Describe the six components of a concept map Identify student responsibilities in concept based learning Describe the basic steps for creating a concept map

“The evolving health care practice arena requires nurses who are capable of providing safe, competent and efficient care within an increasingly complex array of patient care needs and interdisciplinary healthcare teams. More than ever before, nurses must be critical thinkers capable of making constructive contributions to desired health care outcome” (Gul & Boman, 2006).

Defining the Terms Critical Thinking: “purposeful, outcome-driven thinking, which is driven by patients’ needs and guided by professional standards. It constantly reevaluates, self-corrects, and strives to improve” (Popil, 2012). Clinical judgment: described by Tanner (2006) as a flexible and distinct ability to recognize salient aspects of an undefined clinical situation, to interpret their meanings, and respond appropriately” (Gerdeman, Lux, & Jacko, 2012, p. 11).

What is Concept Based Learning? “a guided approach to study of one nursing care concept. Concept-based learning activities provide a way for learners to study specific important aspects of nursing care regarding the concept being studied” (Nielson, 2009). Video: What is Concept Based Learning? (6 minutes): http://www.youtube.com/watch?v=g8fKU9LZ2kw Concept-based learning is a pedagogy that places emphasis on deep learning of specific concepts and de-emphasizes rote memorization of factual information” (Nielson et al., 2013).

What is a Concept? A concept is defined as “a construct or abstract idea or thought that originates and remains within the mind” (Mosby’s Medical Dictionary, 2009). “a word or phrase that summarizes ideas, observations, and experiences…tools that provide mental images that can facilitate communication about and understanding of a phenomena” (Fawcett, 2005, p. 4). Video: “What is a Concept?” (2 minutes) http://www.youtube.com/watch?v=PpCeKSXs7C8

Why Concept-Based Learning? Success in nursing education involves understanding of complex concepts and associated nursing care Students must demonstrate not only knowledge of concepts but application to actual patient situations Ability to critically think and analyze complex situations is necessary when providing safe and effective care to today’s patient Learning must be transferrable across the lifespan and through a variety of clinical settings

Advantages of Conceptual Based Learning Conceptual-based approaches to learning: Decreases duplication of content and content saturation Promotes content management Improves active participation in learning, critical thinking, & clinical judgment Promotes ability to care for a diverse population in a variety of clinical settings Can be presented across the lifespan According to Giddens et al. (2008) the overemphasis of content, the abundance of information, changes in health care delivery, and ongoing teacher-centered approaches has contributed to content saturation. Today’s nursing students are tasked with learning a vast amount of information in a short amount of time. This leave little opportunity for the student to make connections between important concepts. Students have a difficulty time seeing the “big” picture, due to focus on memorizing particular content details. This results in difficulty in applying and transferring knowledge across a variety of clinical sites and diverse patient populations. Today’s healthcare environment is increasing in complexity and patients are presenting with complex medical histories and multiple care needs. Conditions and associated treatments often interact or result in complications. Nursing students must understand the nature of these relationships. Clinical simulation is an example of a conceptual-based learning modality.

Advantages of Conceptual Based Learning Provides a foundation upon which to build future learning Links theory to practice Actively engages the learner and stimulates motivation and interest Facilitates application of concepts learned in didactic courses to clinical situations Promotes development of psychomotor and clinical decision-making skills, teamwork, communication, and delegation Supports adult learning theory (Giddens et al., 2008)

Theoretical Foundation Supporting Concept Based Learning Constructivist Learning Theory Proposes that learners are active participants in the learning process Learners construct new knowledge based upon existing knowledge through personal interpretation of experience Knowledge representation is subject to change as new knowledge is added (Vandeveer, 2009).

Characteristics of Adult Learners Independent Have preferred differences in learning styles Prefer being actively involved in the learning process Desire connection to and support of others in the learning process Have life experiences providing a context for learning (Vandeveer, 2009).

Characteristics of Adult Learners Self-directed Internally motivated to learn Seek to immediately apply new knowledge Have accumulated experience which serves as a foundation upon which to build

Student Responsibilities in Concept Based Learning Adult-learners capable of learning independently Responsible for readings on selected concept & selected patient population Active participation in discussions, case studies, and learning activities Open discussion of patient problems, findings, possible solutions, and techniques Exploration of alternatives and identification of relationships between ideas

Teacher Responsibilities In Concept Based Learning Stimulate reflective thinking and discussion Create a supportive learning environment Promote peer collaboration Facilitate understanding of relationships, principles, & generalizations (promote transfer of learning) “In CBLA, positive regard is used in the teacher-student relationship to encourage a positive attitude in students and reduce anxiety” (Heims & Boyd, 1990, p. 252). Open discussion permits students to reflect upon their thinking, consider alternatives, and make errors in thinking without fear of causing patient harm. Through use of reflective questioning faculty facilitate inquiry and stimulate critical thinking (Heims & Boyd, 1990).

Concepts Concepts that will be covered in this course: (not necessarily in this order) Comfort Tissue Integrity Elimination Diversity Functional Ability Grief Mobility Human Development Sensory Perception Nutrition Sleep Thermoregulation

Concept Mapping Helps learners organize, analyze, and enhance understanding of complex information Serves as a means to document association between two or more concepts in effort to enhance clinical reasoning skills Provides a formula to visualize physiological, pathological, and psychological relationships and interactions in a concrete fashion Nursing and nursing students have traditionally used nursing care plans to provide and organize nursing interventions base on identified needs. Because these plans of care are usually prepared using generic care plans from books, these are traditionally linear, rigid in format, and fail to identify interrelationships between conditions and treatments. The use of concept maps can assist the learner bridge the gap between theory and application in the clinical setting.

Concept Mapping Provides a means to connect and organize links between disease processes, body systems, and physiological effects of disease Provides guidance for developing a plan of care Complex information can be presented “at a glance” May be used to enhance deeper learning of nursing concepts and to promote critical thinking in clinical settings Video: Concept Mapping: (11 minutes) http://www.youtube.com/watch?v=QENMp0K2-Zk Video: Simple Nursing Concept Maps (11 minutes) http://www.youtube.com/watch?v=8sLrbwTPcME “With concept maps, information can be presented in a condensed manner without the loss of complexity an meaning. The image of concepts in a tangible form, can facilitate comprehension through a visual presentation that fosters an understanding of complex information ‘at a glance’.” Gul & Boman, 2006, p. 199).

Components of Concept Map 1. Nursing Care Directed toward what contributes to a normal concept and is thereby related to all factors involved in or with the concept. Not always needed to have a normal outcome. 2. Attributes: Defining characteristics of the concept What must occur for the concept to exist 3. Antecedents: What precedes the concept for it to exist Events or incidents that must happen before the concept

Components of Concept Map 4. Consequences: Negative or untoward events or outcomes that occur due to malfunction within the concept Positive events or outcomes that occur due to proper functioning within the concept 5. Interrelated Concept Concepts which can affect change in the other Concepts which work together to ensure a normal process Concepts which if depleted or impaired can cause a negative consequence in the other 6. Sub- Concept Critical components of major concept

Steps of Concept Mapping Step 1: Identify central concept in the center of page enclosed in box or circle Step 2: Identify all sub-concepts, attributes, antecedents, consequences, and interrelated concepts associated with the main concept Step 3: Link these to the main concept using arrows or lines to signify a relationship Step 4: Identify “linking” words to signify the relationships

Steps of Concept Mapping Critical Thinking Strategies: Concept Mapping: http://www.austincc.edu/adnfac/collaborative/onsite_conceptmap.htm

Questions What is concept-based learning? Answer the following questions under discussion on Canvas NLT August 30, 2014 What is concept-based learning? Discuss ways that conceptual-based educational approaches promote learning. Describe the six components of a concept map. Identify student responsibilities in a concept based learning experience. Describe the basic steps for creating a concept map.

References Cook, L, K., Dover, C., Dickson, M., & Colton, D.L. (2012). From care plan to concept map: A paradigm shift. Teaching and learning in nursing, 7, 88-92. Doi: 10.1016j.teln.2011.11.005. Fawcett, J. (2005). Contemporary nursing knowledge: Analysis and evaluation of nursing models and theories. Philadelphia: F.A. Davis Company. Germeman, J.L., Lux, K., & Jacko, J. (2012). Using concept mapping to build clinical judgment skills. Nurse Education in Practice, 13, 11-17. Doi: 10.1016/j.nepr.2012.05.009. Giddens, J.F., & Brady, D.P. (2007). Rescuing nursing education from content saturation: The case for a concept-based curriculum. Journal of Nursing Education, 46(2), 65-69. Gul, R.B., & Boman, J.A. (2006). Concept mapping: A strategy for teaching and evaluation in nursing education. Nurse Education in Practice, 6, 199-206. Doi: 10.1016/j.nepr.2006.01.001. Heims, M.L., & Boyd, S.T. (1990). Concept-based learning activities in clinical nursing education. Journal of Nursing Education, 29(6), 249-254.

References Nielsen, A. (2009). Concept-based learning activities using the clinical judgment model as a foundation for clinical learning. Journal of Nursing Education, 48(6), 350-354. doi: 10.9999/01484834-20090515-09 Nielsen, A.E., Noone, J., Voss, H., & Mathews, L.R. (2013). Preparing nursing students for the future: An innovative approach to clinical education. Nurse Education in Practice, 13, 301-309. doi: 10.1016/j.nepr.2013.03.015. Popil, I. (2010). Promotion of critical thinking by using case studies as teaching method. Nurse Education Today, 31, 204-207. Doi: 10.1016/j.nedt.2010.06.002. Senita, J. (2008). The use of concept maps to evaluate critical thinking in the clinical setting. Teaching and learning in nursing, 3, 6-10. Doi: 10.1016/jteln.2007.08.002. Vandeveer, M. (2009). From teaching to learning. Theoretical foundations. In D.M. Billings & J.A. Halstead (Eds.), Teaching in nursing. A guide for faculty (189-226). St. Louis, Missouri: Saunders Elsevier