INTRODUCTION:

“The success or failure of teaching depends upon the methods of teaching.”

Even the best curriculum and Teaching should not be just communication and dissemination of information in nursing or any medical field; it must enable a learner in developing a capability to use these ideas and information, thereby formulating a person capable to be in the professional role. One has to enrich the quality of instruction with the right methods of teaching quickened with the traditional methods of indoctrination. Otherwise, even the best curriculum or the most perfect syllabus remains dead.

With a sound knowledge of various teaching-learning methods in nursing, a teacher can improve and improvise the techniques to make the teaching-learning situation more conducive to students. A teacher can be eclectic in using techniques if he has a commendable knowledge of the methods at hand. Teachers always have to attempt innovations in their teaching, in order to improve student learning.

In this article, we will discuss reflective learning, journaling and concept mapping which when implemented in our nursing classes can bring about a vast difference.

REFLECTIVE LEARNING:

Reflection or critical thinking is practiced in nursing, which not only includes our rationale for actions but also constantly explores and evaluates ourselves, thereby constituting professional development and improvement.¹ Re-examining ourselves is crucial, as nursing as a profession is committed to others. Reflections ensure that the procedures are done in the correct step following all the rules, as well as are humane and performed in a holistic manner.² Each and every action; whether right or wrong must be reflected upon, which helps in gaining new insights.

Reflective practices can be a personnel tool for the student for learning as well as a teacher for better teaching.³ Critical observations of a teacher from a different perspective will help identify areas of improvement to better support pupils’ learning experience. Teachers need to admit that no matter how good a lesson is, their practice can always be improved by analysis and evaluation. When teachers practice reflection, they can motivate learners to reflect on, analyse, evaluate and improve their own learning by admitting mistakes, taking ownership, and developing a plan to overcome challenges. Reflections are possible by people with a mindset of growth; that is improving their qualities through effort. Reflective practices may be difficult in the beginning, but fruitful in developing skills and learning.⁴

Fig:1 Reflection process

Advantages of reflective practice:

· Students by playing an active part in the learning cycle become more confident and responsible.

· Allows taking ownership of their learning.

· Creates self-awareness.

· Reflective practice allows adapting lessons to suit classes. One can create and experiment with new ideas and approaches in teaching, which results in a richer learning experience.

· Learners will think more creatively, imaginatively, and resourcefully, and are ready to adapt to new ways and methods of thinking.

· It helps to move on and do better, learning from experience which in turn can improve the quality of patient care.

An example of reflective thinking by nursing students:

Scenario:

A student nurse posted in the paediatric ward was assigned 4 patients. She had a bedside case presentation with the teacher too. She was standing and just reading the patient file and enquiring in between. The parents and children were annoyed by the way the student was asking questions.

Implementation of reflective learning:

When reflective learning is used, the student should try to analyse what went wrong. She has to first focus on her aim which is gaining cooperation from the patient side as well as doing her presentation simultaneously. She has to realize that she was distracted by the workload she was having and didn’t maintain a working relationship in the initial contact with the patients and bystanders. She would have taken some toys or some activity books to interact with the child first. That is her conduct should be changed. She should not be surprised by the anger they are showing. Approach in a friendly way and by open communication. In between, ask whether they are happy with the explanations she is providing. Thus, try to do things differently the next day. Later she needs to reflect on the newly executed actions. She might see the improvements she has made.

For reflections to be meaningful conclusions must be reached that is whether it was success or failure, then only it can be a valuable learning tool.⁵

JOURNALING:

In education, Journaling is deﬁned as “writing about learning experiences; which leads to the development and growth of judgment, personal values, and critical thinking skills”.⁶ It can be a free writing activity or guided questioning. Within nursing, it involves the activity of writing about experiences following clinical and simulation experiences. In clinical settings, journaling can be implemented when the educators ask the learner to describe a scenario, reﬂect on it, connect ideas, and improve upon it; if it was experienced again or ask how they have changed because of it.

Journaling is commonly used to discuss cultural values, ethical considerations, therapeutic communication, interprofessional collaboration, and dialog. It is also appropriately used as a supplemental debrieﬁng method following clinical simulation.⁷

Teacher’s role:

· Teachers need to write down what happened, noting their own reactions and feelings, as well as those of the students after each lesson. (This relies on a teacher’s ability to recall things in as much detail as possible and the time to do it on a regular basis.)

· The teacher has to explain the purpose of journaling and his or her expectations in regard to content, reﬂection, and length to the student.

· Teachers are responsible for providing guided questions that represent the outcome the educator would like to achieve in regard to student learning.

· The teacher has the responsibility to review the learner's completed journal, provide thought-provoking questions and comments, and help merge ideas that remained unconnected.

· The teacher should use information about identiﬁed weaknesses to help shape learning for that student in the future.

· Teacher provides a grade when it is used as an assignment based on a points system or completion grade.

Role of the learner or writer of the journal:

· Use guided questions or thoughts about their experiences to stimulate thinking and explore meaning.

· The student should reﬂect on their own growth and follow teacher-outlined expectations related to content, depth, and length.

· The learner also has the responsibility to make sure the journal, if used as an assignment, is submitted on time and with substantive depth.

Advantages:

· It helps the student to connect and apply information learned in the classroom to the clinical learning environment.

· Helps students see their own strengths and weaknesses in a learning area

· Students can take a scenario and plan how to improve on it in the future. Therefore, it encourages reﬁnement of action in different health care situations.

· The journal can provide guidance and direction for the nursing student in his or her thinking while learning new aspects.

· Higher levels of reﬂection in students' journals are associated with higher scoring on examinations and overall grades.

· Students express an increase in self-awareness regarding knowledge and emotions

· Journaling provides an emotional outlet where students can explore emotions related to emergency situations, new experiences and situations, and emerging values and social responsibilities.

· Journaling helps the students to cope with stressful nursing programs.

· Some students may feel that it creates a more intimate bond with the nurse educator that helps to increase learning.

· The students are able to reﬂect back on their experiences in order to improve them, and the instructor can gauge the students' learning, judgment, and critical thinking skills.

· Journaling can also help to develop a student's writing skills as they learn to transfer thoughts to written information.

A sample evaluation tool for journaling

Areas to be assessed	scores
Areas to be assessed	0	1	2
Degree of reflection	No reflection, experiences are just listed	Some reflection is evident	Deep reflection is evident
Application of theory	No theory components are correlated	Some integration from readings/lectures to experience	Strong integration from readings/lectures to experience
Analysis for future improvement	No thought towards improvement	Some thought towards improvement, not well developed	Well-thought plan for future improvement
Development of values	No value development indicated	Some value development mentioned but not well-developed	A full exploration of a change of one or more values
Degree of completion	Not completed	Not all questions were answered, short response	Full journal entry, meeting length requirement
Total Points ___/10

Drawbacks:

· The writer may feel embarrassed and may not write truthfully if they do not trust the reader. Some students believe that it is an invasion of privacy or is worried about their private thoughts being shared.

· Some studentsview the assignment as busy work and not put much effort into the assignment.

· Grading journals is complicated because it is difﬁcult to objectively grade subjective experiences.

· It can also be time-consuming and labor-intensive for the educator to read and provide thoughtful feedback.

· Clear expectations need to be set because the students need to understand what is expected of them.

Recent Trends in journaling:

More recent journaling trends focus on journaling with the combination of technology.⁸ For example, journaling following high-ﬁdelity simulation. Another focus is on journaling from within learning management systems, online discussion groups, and blogs. Yet another new focus is journaling within advanced practice nursing programs.

New journaling trends are changing and reﬂect an expansion of health care needs and technology growth.⁹ Further, research is needed regarding the comparison of evaluation methods and journaling between clinical areas.

CONCEPT MAPPING:

A concept map is a way of representing information, knowledge, or facts in a graphical form.¹⁰ Concepts and their relationships are illustrated in a visual/graphical model by concept mapping, so as to easily grasp the material by breaking down large topics into smaller pieces and thereby understanding relationships between concepts. Concept mapping is the best solution for studying nursing topics that need extra time and effort. It makes the studies easier and helps in developing critical thinking skills like creating, analyzing, and evaluating. From a single picture, a student can understand how everything is related to each other. Deep and meaningful learning is possible from concept maps compared to lecturesor other methods of teaching.

Concept maps in nursing are used as a method of combining practice and theory - a studying technique of nursing students; a method in which students can more easily identify the subjects better that they do not know and understand, and has a positive effect on their academic success.

Concept maps can be in various forms (spider, hierarchical, flow charts, etc.). The various steps for creating a concept map is: choosing a topic, thinking about the audience, selecting key concepts, adding familiar concepts in between, place concepts on map and connect concepts with relationship. The direction of the relationships must be created in such a way that they can be followed. Concept maps serve their purpose best if each student develops the map by themselves, or at least edits a map created by someone else, adapting it according to their needs.

Fig. 3 Sample Concept Map

The use of concept mapping in clinical learning activities improves critical thinking and enables the students to evaluate what they have learned and what they need to learn.¹¹

When implementing concept mapping, learners think and learn with concepts, making concepts meaningful by connections between concepts that are developed in the learner's cognitive structures. teaching and the right kind of teachers”.

Advantages:

· Provide a quick, systematic overview of the given topic.

· Emphasize relationships among concepts.

· Can encourage collaborative learning.

· Can be used to actively involve students by giving them a partially filled map to be completed.

· Promote good visual recall memory

· Can serve as a basis for discussion.

· Encourage critical thinking

CONCLUSION:

We must re-engineer our teaching-learning system, which will promote quality. Every teaching method will be a success if the teacher decides and puts effort. Teachers should embrace newer methods each day, which will make learning interesting to the students. There must be a high commitment on the part of a teacher.

REFERENCES:

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11. Available from: https://irp.cdn website.com/73a66fd2/files/uploaded/Concept%20maps%20in%20education.pdf

12. Derbentseva, N. & Kwantes, P., 2014. Cmap readability: propositional parsimony, map layout and semantic clarity and flow. In Concept Mapping to Learn and Innovate. Proceedings of the Sixth International Conference on Concept Mapping, Brazil.

13. Woodward, H. (1998). Reflective Journals and Portfolios: Learning through assessment. Assessment and Evaluation in Higher Education, 415-426.

14. Mythili D, Sailaxmi Gandhi, Thirumoorthy. A, Muralidharan. K. Short-Term Impact of Traditional Versus Innovative Teaching Strategies on Mental Health Knowledge among Undergraduate Nursing Students in India – A Pilot Study. Asian J. Nur. Edu. and Research 5(1): Jan.-March 2015; Page 08-11.

Received on 09.11.2022 Modified on 23.01.2023

Asian J. Nursing Education and Research. 2023; 13(2):119-122.

DOI: 10.52711/2349-2996.2023.00026