Critical Reflection

This post will reflect on and discuss the following quote. “learning from one’s experience involves not just reflection, but critical reflection” (Merriam & Bierema, 2014, p. 117).

Objective

This quote comes at the end of section in which the writers have described reflective practice as “learning acquired through reflection on or in practice” (Merriam & Bierema, 2014, p. 115). An example of this is within professional preparation programs in which the learner learns skills while on the job. Critical reflection is described as “a more postmodern and critical stance on reflective practice” (Merriam & Bierema, 2014, p. 117) in which the reflection is much more in-depth than just reflecting on how well the student feels they performed the skill. The critical reflection is when the student determines and names the assumptions that they have when performing a newly learned skill. It is when the learner analyzes their assumptions and compares them to how they experience reality. The student can then adopt and integrate their assumptions as their new reality…a newly learned idea (Merriam & Bierema, 2014). This quote caught my attention as reflection is a large part of new learning in the field of nursing. However, the term ‘critical reflection’ was a new term for me and I was interested in learning more about it.

Reflective

I chose this quote because I strongly agree with the use of reflection in the both personal and professional learning. As a nursing educator, I use reflection as a technique with nurses within the hospital who are maintaining and advancing their practice and skill. I often use the technique after a skill has been performed and I ask the nurse how they felt they did. Nurses are taught to be self-reflective and generally are very insightful into their own practice. Most of the time nurses often will explain what they liked about what they did and what they would do differently next time and why. I have also used this technique in a group discussion format to give nurses a chance to debrief about a situation that occurred. When the technique is used in a group setting, those who are out-loud processors can learn by discussing the situation and those who learn by listening and thinking quietly can also learn from the discussion. What I have not had much time is to use the more in-depth critical reflection as it would take quite a bit more time to do that. This is perhaps where encouraging the nurse to journal on their own time may be the next step.

Interpretive

I have always believed that reflection is a key part of a student solidifying their learning, but I wanted to know how critical reflection is important. When I looked deeper into the topic I found a handout on the Virginia Commonwealth University website that explains that through critical reflection students “analyze concepts, evaluate experiences, and postulate theory. It provides students with the opportunity to examine and question their beliefs, opinions, and values. It involves the student observing, asking questions, and putting facts, ideas, and experiences together to derive new meaning. Critical reflection promotes personal development by enhancing students’ self-awareness, their sense of community, and their sense of their own capacities. It enhances students’ critical understanding of the course topics and their ability to assess their own values, goals, and progress” (The Importance of Critical Reflection, 2011, p.1). It is obvious to me that critical reflection is a way for the learner to develop a much more solid learning experience as they take a deeper dive into their own values and beliefs. When this type of learning is done, the learner is builds on their knowledge in the affective domain. I believe that if learning is done in conjunction with an emotional reaction to the experience or material, there is less of a chance that the learner will forget what they have learned.

The article also quotes John Dewey saying, “truly educative experiences generate interest, are intrinsically worthwhile, present problems that awaken new curiosity, and creates a demand for new information, and gives the learner time to foster new development (The Importance of Critical Reflection, 2011, p.1). I truly want the nurses I work with to intrinsically desire to become better all round nurses. I want to awaken their curiosity and generate more interest.

Decisional Thoughts:

As I read through the handout on the Virginia Commonwealth University, I found suggestions of how to apply critical reflection in different settings. The ORID Model (objective, reflective, interpretive, decisional) was an example of how to enable students to critically reflect just like in this PIDP 3100 assignment! I have been critically reflective in this course without even knowing it! The article also discusses use of group discussions, portfolios and notebooks, presentations, simulations and role playing, electronic forum, and engaging the community. This supports my use of group discussions for learning within the hospital setting. What I may also integrate into my teaching is more opportunities for simulation and role playing. This takes some time up front to write case studies, set up the lab and then find opportunities for staff to leave join while on shift and often staff are not keen to come in on their day off. We have integrated mock code blue scenarios within the work day and rotate between different units so as to give many different staff an opportunity to practice being in a code blue situation. We debrief after the mock code with the group, but for some nurses, encouraging them to journal about this may also be important to enhance their learning even more. There is a Facebook group for our nurses who work on the medical unit. I am going to think more about how I may be able to integrate some learning opportunities on this forum.

In Conclusion, I feel excited to integrate more opportunities for nurses at my hospital to use critical reflection to enhance their learning so as to give more opportunities for nurses to advance their knowledge and skill and to foster a desire for more learning and to awaken new curiosity and a desire to be the best nurses ever.

 

References

Merriam, S.B. & Bierema, L.L. (2014). Adult Learning: Linking Theory to Practice. San Francisco: Jossey-Bass.

Service-Learning@VCU. (2011). The Importance of Critical Reflection. Retrieved from: http://wp.vcu.edu/servicelearninginstitute/wp-content/uploads/sites/278/2011/10/Critical- Reflection-Handout-2012.pdf

 

A Reflection: Education for the Generations

This post will reflect on and discuss the following quote written by Daniel Pink, on page 218 from his book titled Drive (2009), “Carrots and sticks are so last century” (Merriam & Bierema, 2014, p. 147).

Objective

Daniel Pink’s summary statement, “carrots and sticks are so last century”, is a really bold way of saying that it can no longer be assumed that adults learn by being bribed by a better life or more pay and cannot be motivated to learn with the promise of approval by others. In other words, people are no longer motivated extrinsically. He argues that adults are motivated intrinsically by their own personal interest in the work they do and by the benefits of self-directed learning. It leads me to think about the learning needs and motivations of the nurses I work with in all generations, especially the millennials.

Reflective

I chose this quote because I am very interested in what will intrinsically motivates adults to learn and grow. I want to understand what will help the nurses in my workplace to become invested in the work they do and the patients that they serve to the point that they will seek out feedback and seek out ways to improve in their practice. I work with adults across the working lifespan (about 21-65+) and find that the different generations represented are so different in how they learn, what makes them interested in learning, the topics they are interested in and how they apply what they have learned to the workplace. I searched for information about how the different generations are motivated to learn and found an article from the Training Journal titled Learning & Development: Across the Generations (2017) written by Steve Macaulay and Sarah Cook. They suggest that first of all, “’mastery’ or development is an intrinsic motivator for all age groups”. They say that Baby Boomers are less likely to use social media for learning or seek regular feedback than Gen X or Y. They accept more top-down approach to management and prefer personal contact and face to face learning. They are less comfortable with technology and social media is not their primary way of communicating. The authors explain that Gen X’ers like regular feedback and mentoring with more structured development and prefer on the job learning. The Gen Y’s thrive in their world of constant communication through technology. They want regular feedback about how they are doing which is what they get through engaging with social media. They want to learn on the job with regular coaching and regular feedback.

Interpretive

The quote by Daniel Pink, “carrots and sticks are so last century” has led me to seek to understand how the different generations think, learn and how they work. Just like generations before me, I find myself frustrated with the next generation and commenting on how good it used to be and what has happened to the next generation?? I do however want to understand the generation before me and the generation after me in order that I may tailor my education delivery to the needs of those whom I serve. As a nursing educator much of the work I do is on the job training. Now that I have done some of this reading, I am convinced that the joining of all of the generations in the workplace is much more of a benefit than a drawback as long as we utilize the strengths that each generation brings to the table and work as a team. In an article by Marilyn Phillips in the Medsurg Nursing journal, she writes about how to embrace the multi-generational nursing team by recognizing and embracing the different ways in which each generation communicates while focusing on patient care and mutual team goals. She explains that Baby Boomers are extremely loyal and strong willed with an ability to delay gratification. Boomers need to be recognized for their contributions through promotions, monetary gain or the ‘corner office’. Boomers see overtime as a moral obligation and the success in their job is strongly related to their self-worth. Generation X’ers are self-directed, independent and resourceful. They appreciate a good work-life balance and seek a good quality of life. The Millennials are extremely connected through social media and are used to many after school (out of work) activities. They are optimistic and seek immediate feedback about their performance. They strive for balance between work and social/home life and they seek job portability and flexibility to have their job fit into the rest of their lives. They have a great sense of morality and civil duty (2016).

Decisional Thoughts:

This information is extremely valuable for me as I forge ahead in my attempt to support nurses of all 3 generations in the delivery of excellent, standard-based nursing care at our hospital. When educating and engaging with nurses of different generations, I plan to continue to assess each individual nurse independently of another to ensure that I am meeting each one’s individual learning needs. I will keep the information that I have learned about the different generational characteristics in mind as I set up learning opportunities. For example if I have a group of Baby Boomers, who are learning a new skill, I will want to ensure that I first recognize, acknowledge and give them time to share their extensive experiential knowledge before presenting the new material. If I am teaching the Gen X’ers, I with ensure that the educational material is mixed with multi media learning as well as opportunities for self-directed learning. I can do this by showing them how to perform the skill first and set them up to practice but leave them to practice on their own. When I return after practice time, I will offer them feedback on their performance to reassure them they are performing the skill correctly. If I am teaching Millenials, I will be sure to incorporate quick and to the point information that they can relate to and practice right away. While they are practicing, I will make sure to give them immediate feedback about their performance in order to satisfy their need for quick communication. As they are used to using media, I may use different forms of media to present the material as well as offer ways to engage with the material via their phone. In fact, I am planning to look into a way to have an Instagram or Facebook account for the nurses to build an online learning community that is just for our medical nurses at our hospital. This would add another dimension of communication to our paper forms of communication such as posters and signs that we post around our unit. I think that even some of the Baby Boomers would engage with some online chatter with the Millennials and the Gen X’ers if the topic was interesting and helpful for the team as a whole to support each other with learning better ways to deliver safe and excellent nursing care to our patients.

When representative from all generations are together learning, I believe that nurse’s learning can be enhanced by the different forms of learning that each generation appreciates. In a group learning setting, if I give nurses an opportunity to share their knowledge, provide the information in a wide range of ways from paper learning, discussion and use of media. If I provide time to work alone or in small groups to problem solve case studies and offer practice time with either peer or instructor feedback within the same session. I hope to engage all individuals within the groups even when each generation is represented

 

References

Macaulay, S. & Cook, S. (2017, March 21). Learning & development: Across the generations. Training Journal. Retrieved from https://www.trainingjournal.com/articles/opinion/learning- development-across-generations

Merriam, S.B. & Bierema, L.L. (2014). Adult Learning: Linking Theory to Practice. San Francisco: Jossey-Bass.

Phillips, M. (2016, May-June). Embracing the Multigenerational Nursing Team. Medsurg Nursing, 25(3), 197-199.

Empathy in the Classroom

Please watch this video presentation by Bréne Brown titled Daring Classrooms.

Play Video

It is about 33 minutes long but very entertaining, challenging, and enlightening.

Bréne says that in order to be able to feel love, belonging, joy, to have courage, empathy, trust, innovation, creativity, accountability, hard conversations, to give feedback, to problem solve well and to make good ethical decisions, you must be able to be vulnerable.  Vulnerability is crushed by shame.  Bréne explains that when students experience shame it inhibits the ability to learn, to be creative, to be innovative, etc.  She explains that a classroom that allows racism, classism, hate speech, name calling, humiliation, favoritism, and gossip is a  place that does not allow learning to occur.  These things essentially eliminate the ability of the student(s) to be vulnerable.

Learning is inherently vulnerable.  As a teacher, you can develop shame resilient classrooms.  Shame is the intensely shameful belief that we do not belong or that we are unlovable.  The antidote to shame is EMPATHY.  Empathy says that you are not alone and others say that has happened to me too.  If you don’t feel alone, you cannot stay in shame, therefore you can enhance learning by encouraging an atmosphere of acceptance, love and allowing each other to make mistakes.

My thoughts about what some rules in the classroom or the workplace could be based on what Bréne has spoken about:  Recognize that a mistake made by someone is not who the person is.  No name calling not even to ourselves.  No bullying.  No favoritism.  No gossip.  No one is alone.  Encourage “empathic failure” no mistake is a failure, in fact when a person fails it means they tried and are now learning from what didn’t work.  this is sometimes the best way to learn especially if we do not feel ashamed by our mistake.  Get up, try again.

A Conversation Summary with my Learning Partner: Adult Education Trends within Arts + Design.

book-bookcase-books-1166657I love being a nurse; many of my friends are nurses and much of my time is spent with people in the nursing or medical field. Yesterday, I met someone who although is not a nurse, is someone with great talents, is extremely smart and creative and most of all very enjoyable to talk to. Kristina Fiedrich is a fellow student in 3100, a class in the Provincial Instructors Diploma Program (PIDP).  She has had a very robust career as an artist and a scholar and within the last year has been working as the Coordinator of Design + Media at Emily Carr University in the Continuing Studies Department. She is taking the PIDP to enhance her knowledge and improve her ability to support and advise instructors who teach in her Continuing Studies Dept.

Through our discussion, Kristen explained that she recognizes a trend in adult education specifically at Emily Carr in which diversity within the student population has become more extreme over the years. She explained that diversity within the student population includes those from many different cultures including our own Aboriginal people, new immigrants from many different nations, as well as those from Canada who have a personal expression of gender and sexual orientation. She explained that as an Arts University the issues about diversity are not new and are both a formal and an informal part of the different curriculums that are being taught. What she is seeing is that even though diversity in theory is embraced, the challenge is how diversity is actively respected in the classroom where each student has the freedom to speak about what they think and feel. The issue is when a student takes advantage of that freedom and use the classroom as a platform to spew hate speech which in turn creates a toxic environment. This is very difficult for the instructors to manage and to create a safe space for students, of all kinds, to learn.

We also discussed online learning.  Kristina shared that she prefers classroom learning where she can be an active participant in discussions with her fellow classmates about the topics that are presented in class.  As a Vancouver resident with many different options for access to post-secondary continuing education, she could see how online learning could be beneficial for someone like myself who lives in more of a rural area where the options for formal learning are limited.   She also agreed with the idea of having the freedom to learn when it fits into a busy schedule.

All in all, we had a wonderfully engaging discussion about trends in adult education in our fields of work and I look forward to our next interaction.

For more information about Kristina, check out her blog.

MOOC: A Trend in Adult Education

Digital learning…not only is it a trend in nursing, but also in adult education.  For those people who love to learn new things on their own time, searching for a MOOC to sign up for is like being in a candy store!!

A MOOC is a Massive Open Online Course in which students can have unlimited participation and open access to a variety of courses via the web.   A MOOC provides traditional course material including filmed lectures, readings and interactive courses that students access online.  There are often user forums available for students to interact with other students, professors and teaching assistants about the educational material being presented including a place to give/receive feedback  on quizzes and assignments.   The best thing about a MOOC is that it is free or a minimal cost to the student.  (Wikipedia).

Check out edX, a website that was founded by Harvard University and MIT in 2012 in which learners can find a plethora of high-quality courses offered by the world’s best universities and institutions. This website calls themselves a “Global Learning Community” in which students will join from every country in the world. EdX is founded and governed by colleges and universities and is an open-source platform and a non-profit organization (retrieved from edX/About Us).

Check out the Introduction to Simulation Education in Health Care from the University of Tennessee.  The cost of this course is FREE unless the student wants a certificate which costs $50 USD.

Enjoy finding a course that fits where you are at in your life right now!!

 

 

Technology, a trend in nursing that is not going away.

Nursing is a profession that tends to change or develop over time. Since 2007, I have had the opportunity to serve my community in a number of different nursing roles. I have provided nursing care to individuals in their home, those in need of palliative care, supported safe patient discharges from hospital to community and have taught nursing to students just learning how to be nurses and nurses working in their field by supporting their ongoing learning. One of the main trends that I have seen in nursing in my community is an increased use of technology both by individuals, within the healthcare setting and within nursing education programs.

According to Dan Weberg, PhD, RN, in an article titled, “Innovation Needs Nurses“, in the American Nurse Today, as more resources come available for our smartphones, nurses will be able to access information and perhaps even use their phones to streamline their work. He suggests that artificial intelligence (a machine’s ability to use algorithms to work through data and find patterns) will be more readily used to help nurses manage increasingly complex patient care. He also discusses how virtual reality and advanced simulation tools will be tools that can be used to help nurses learn more and learn faster (2018, p. 35).

Nurses are using their smart phones regularly to access online resources that are meant to improve their nursing care. The Nurse Journal: Social Community for Nurses Worldwide has an article that gives information about the 19 Must-Have Mobile Apps for Every Nurse. The tricky part with smart phones is that many hospitals have policies against using electronic devices in patient care areas. Many patients and families don’t appreciate seeing a nurse on his or her phone instead of providing patient care. Nurses must be wise and exercise professionalism when choosing the right time and place to use their phones even if it is to support their practice.

The Home Health program in our community just standardized electronic clinical documentation in March 2018 which eliminated paper documentation. This allows for the patient’s health record to follow them through their health journey. When the patient goes in to the hospital, the information in their electronic record can be accessed and utilized to provide continuity of care. The electronic record is only partially used within the hospital and therefore at times can be something that some staff are very efficient at using and others are not. The other drawback is that in some areas of the hospital, there are not enough computers and definitely not enough time for nursing staff to look up information about their patient in the Home Health chart. The irony of this is that technology is meant to make nurses lives easier but this is perhaps not yet the case in this situation. It is going to take time and a dedicated effort to teach the nurses how to find the patient’s electronic chart and also time to do it.

Use of technology in nursing education is also on the rise and being used in nursing programs within our community and our province. Many nurses are keen to continue their nursing education but must do so via online learning in order to keep their full time job to pay for the courses they are taking. Living in a small community can limit the opportunities for master’s or doctorate level education. Our local educational institutions do not provide such high levels of nursing education and therefore nurses are forced to pursue advanced education courses via online programs such as a Master’s in Nursing from UBC or Athabasca University. I am one of those nurses who is completing my Provincial Instructors Diploma online through Vancouver Community College.

As a nursing educator within our hospital, a common comment that I hear is that nurses feel that they have less time to spend at the bedside with their patients and have to spend more time looking up information on a computer and more time doing paperwork. The art of nursing traditionally doesn’t include being good at using a computer or more advanced machines. For some, using machines causes tremendous amounts of stress and even causes nurses to feel a sense of frustration when they spend more time away from the bedside caring for their patient. I suspect that technology is going to continue to change the way we provide nursing care in the hospital but the difficulty will continue to be educating those who are not technologically inclined. As an education team in our hospital, we must support nurses in becoming good critical thinkers who provide safe and effective patient care but also nurses who are knowledgeable and confident when using the machines or computers required in the patient’s care as well. Our education programs must include hands on learning and practice with the machines to ensure that they are not only competent to provide care with these machines but also feel comfortable and confident. The use of case studies is important for a nurse to be able to use the machine in a simulated way in order to ensure they can use the machine in a ‘real’ way.

Technology is not going away and will completely change the landscape of our healthcare system and the way nursing care is delivered over time. It is extremely important as a nursing educator to remain as knowledgeable as I can with the new technologies being implemented within our hospital in order to be able teach the nurses how to use the new technology and to encourage them to embrace it and the changes it brings to the delivery of nursing care in a positive way.

The First Day of Class

http://cfe.unc.edu/pdfs/FYC1.pdf

The Center For Faculty Excellence  of the University of North Carolina (2009) put out the article: The First Day of Class.

It may seem funny for me to be thinking about my first day of classes with my upcoming class at the end of August when I have just finished my last day of classes with my current students.  It is however how we educators think.  We must compile student feedback and also our own thoughts about how the past year has gone in order to plan for how we can improve things for next year.  It is tempting to finish the last class and run out the door never to look back until the end of August.  By then, we may have rejuvinated, but we may also have forgotten some of the things we wanted to change or the feedback that was important for us to make things better next year.  So, here I am reflecting on how some of the things went in my classroom this year.  I found this wonderful article about how to clearly communicate and set the stage for learning with the new students on day one.  This has helped me to reflect on what I did last year and to think about what I liked and what I want to change about my first day and my first week with the new group of students.

I hope this article is helpful to all of you educators out there as well.

Connie