Conversational Model of Learning in Nursing

Introduction

The present paper follows the progress of the development of an in-service education program that is meant for twenty-six nurses of the Emergency Unit of the King Fahad Medical City, which is located in Riyadh, Saudi Arabia. In particular, the paper uses the information gained through the learning needs assessment to consider the theoretical underpinnings of the program, which is the conversational model (CM).

CM views the learning process as a form of a conversation between the learner, peers, and teacher and emphasises both the individual and social aspects of learning. In the paper, the specifics of CM are discussed and reviewed from the perspective of constructivism, cognitivism, and humanism, after which the value of CM for nursing programs is established. The significance of CM for the proposed program and its potential impact on the learning group members, who are characterised by their varied experience and education, are also reviewed. The use of multimedia in the program based on CM is also considered.

Conversational Model

CM describes the interactions between the participants of the learning process, including the learner and their peers and teacher (Atif, 2013; Stephens, & Hennefer, 2013). The interactions consist of the participants’ activities, in which the teacher translates the knowledge available to them and develops (constructs) the environment that would evoke a response from the learner.

As a reaction, the learner shares their understanding of the received information and performs the tasks required of them (together with their peers), using the newly gained experience, results, and feedback to reflect on their new and existing knowledge. The teacher also employs the observed and reported information on the learning process to adjust the goals for the learner and, possibly, improve the program itself (Holmberg, 2016). These activities develop a continuous conversational relationship between the participants.

CM is learner-centred, but an important advantage of CM is its focus on the relationship (conversation) between the participants (Knewstubb, 2014). As a result, both the internal, individual learning process and external, social processes are recognised by the framework (Holmberg, 2016). Therefore, the collaboration is similarly central to CM, and it is supported by multiple mechanisms like specific teaching approaches, environmental design, and the employment of various tools, including multimedia elements (Atif, 2013). These defining features of CM can also be considered from the perspective of existing learning theories.

Constructivism

From the perspective of constructivism, knowledge depends on the standpoint of the learner and is constructed from their experiences, which are often connected to environmental stimuli (Cadorin, Bagnasco, Rocco, & Sasso, 2014). Thus, the learner is the central figure from this perspective, and the teacher is expected to encourage the learning process (Kay & Kibble, 2016). CM also views the learner as an active participant who is prompted by the teacher, peers, and the environment created by the teacher. This learner-centredness and attention to external stimuli can be viewed as some of the similarities of CM and constructivism.

Moreover, social constructivism also highlights the significance of the interaction as one of the stimuli (Duane & Satre, 2014), and social interaction is a key aspect of CM. Finally, communication and collaboration are similarly characteristic of both constructivism and CM (Duane & Satre, 2014). Therefore, it can be suggested that CM can be connected to constructivism and social constructivism.

Cognitivism

Cognitivism is an approach to interpreting the learning process which focuses on the process of acquiring, constructing, representing, and remembering knowledge (Kay & Kibble, 2016). From this perspective, the learner is viewed as an active subject, who possesses some specific features and behaviours that can affect the learning process. Such learner-centredness is characteristic of CM as well, which connects the two phenomena. On the other hand, cognitivism neglects the environment (Cadorin et al., 2014), which is a primary difference between this learning theory and CM. As a result, while certain similarities can be found between the two, CM can only be partially explained by cognitivism.

Humanism

Humanism is another learner-centred theory, which highlights the need for supporting the learner’s education through the development of appropriate environment (Balakrishnan & Gan, 2016). From this perspective, the teacher only facilitates the process of learning to help the learner engage in it autonomously. CM incorporates the concept of teacher-developed supportive environment, and the framework is decidedly learner-centred. Therefore, certain parallels can be drawn between humanism and CM, and the latter can be explained by the former.

Application: Curriculum Development

The value of CM for the program

The specifics of the learning group is of interest from the CM perspective. The King Fahad Medical City recognises the need for continued education of its staff, and it has allowed assessing the learning needs and demographics of the nurses of its Emergency Unit. The process involved administering a questionnaire with various types of questions (from open-ended to closed-ended ones). As was discovered during the assessment, the nurses who are going to participate in the program have different levels of experience (between three and ten years) and education; also, their ages range between 25 and 48. This information can help to determine the benefits of using CM for the program.

First, it is important that the program is meant for nurses. Certain approaches to education are proven to be especially helpful when working with nurses. For instance, reflection is crucial for nursing education (Brown & Schmidt, 2016), and CM provides multiple opportunities for reflection both for the learners and teachers. Similarly, collaboration and co-learning are characteristic of nursing education (Schmidt & Brown, 2016), and, as it was mentioned, CM involves cooperative learning and peer and teacher interactions.

Moreover, it has been discovered that collaboration during education can offer learners some emotional support and promote personal connections (Walji, Deacon, Small, & Czerniewicz, 2016), which is a positive outcome for a team of nurses. On the other hand, the fact that the nurses have been working together may mean that they have already developed meaningful connections, which may make them more interested in supporting each other and sharing knowledge. Thus, CM appears to be most appropriate for nursing education, which is why it is helpful for the planned program.

Another specific feature of the program is that it focuses on the nurses who have already had some level of experience. The differences in their experience, as well as backgrounds and education, suggest that during their collaboration, they are likely to engage in knowledge and perspective sharing, especially if provided with appropriate incentives by the teacher (Lin & Lo, 2015). This factor should enhance the process of learning.

Moreover, in-service education is typically connected to the reflection and comparison of the information provided by the course and that experienced by nurses (Sevin, Hale, Brown, & McAuley, 2016). Given the fact that CM offers multiple opportunities for reflection, its value for the program, as well as in-service education programs in general, is proven again.

Finally, due to its reliance on the conversation, CM is also capable of enhancing the educational programs that are based on it. In fact, participants can contribute to the development and customisation of the program through their conversations and feedback (Atif, 2013). Therefore, the value of CM for the program is not limited to the fact that it is appropriate for the learning group and can enhance the process of their learning; CM can eventually be beneficial for the program itself and help it to improve.

Examples of multimedia use

CM hinges on the interaction and communication between participants, which should be enabled through a variety of channels and media. As a result, the employment of multimedia tools, which combine various types of media, seems to be appropriate for the framework. The use of the opportunities suggested by multimedia for nursing education is proven to have positive effects on knowledge acquisition and learner satisfaction (Liaw et al., 2015). The proposed program is going to employ multimedia to help the nurses review the topics that have been chosen after the analysis of their educational needs.

The needs assessment shows that the majority of the nurses who are going to participate in the program are interested in using video demonstrations for educational purposes. This type of multimedia was chosen as the preferred one by 80% of the participants. This method of instruction has been relatively popular in the past years. It has been proven to assist in understanding and remembering the key points of a lecture while also enhancing the organisation and presentation of a lesson and improving learners’ attention and engagement (Ljubojevic, Vaskovic, Stankovic, & Vaskovic, 2014).

These benefits have been found in employing video specifically for nursing education as well (Forbes et al., 2016; Holland et al., 2013). For instance, CARNA Videos (2014) offer a short (less than three minutes) video on medication error reports, which can be found here. It includes a case study with a thorough analysis of the need for medication error reporting performed by a registered nurse. Medication error is one of the topics that are going to be reviewed in the proposed program, and this multimedia tool is going to be employed to enhance the learners’ experience.

Other types of multimedia are also going to be used. For instance, interactive tools, including tests, are known to augment the acquisition of knowledge and learner satisfaction and engagement (Liaw et al., 2015; Petty, 2013). The Learning Nurse Resources Network (2017) offers multiple tests on nursing, including that on medication errors, a short version of which can be found here. This example employs text, sound, pictures, and various interactive elements in order to test nurses’ understanding of medication errors and provide them with correct answers. This multimedia tool can be used to check the nurses’ knowledge in an engaging and interesting way that is consistent with the program’s theoretical underpinnings.

Conclusion

Having reviewed the program’s theoretical underpinnings, the paper can offer the following conclusions. CM is a framework that can be consistent with the learner-centred learning theories, including constructivism, cognitivism, and humanism. However, the lack of attention to the environment that is exhibited by cognitivism is not in line with CM; rather, CM makes an effort to highlight the significance of individual and social aspects of learning, demonstrating the way the meaningful conversation between participants results in knowledge acquisition, reflection, and development.

Due to its features, CM can be helpful for in-service nursing education programs, including the one proposed by the paper. The features of collaboration and reflection are especially valuable. Finally, CM supports the use of multimedia in education, which the program intends to do. In summary, CM is apparently appropriate for the program.

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