Conceptual Learning: What? Why? How?

1. Conceptual Learning:What? Why? How? Sheryl K. Sommer PhD, RN, CNE Vice President Nursing Education and Consultation Services

2. Objectives • Describe Conceptual Learning. • Examine the need for ConceptualLearning. • Explore approaches to Conceptual Learning.

3. Conceptual Learning • The integration of new information with existing knowledge, through the use of CONCEPTSapplied to CLINICAL SITUATIONS, to promote DEEP UNDERSTANDING across time and situations

4. Conceptual Learning: What? • Traditional learning • The acquisition of knowledge by focusing on what the student must KNOWand be able to DO, with limited emphasis on developing deep understanding • The instructor organizes and presents information determined to be most important

5. Conceptual Learning • Concept Based Curriculum • The structured use of unifying CONCEPTS(classifications or principles) and EXEMPLARS(diseases/conditions) in the curriculum to frame learning and facilitate the acquisition of knowledge. (Giddens, 2013)

6. Instructor and Conceptual Learning • Role of the instructor • Facilitate knowledge acquisition • Guide situated learning • Help students develop a sense of salience by distinguishing between valuable and invaluable information

7. Group Activity • Share an experience when your approach to teaching about a nursing topic did not produce the outcome you desired. • Why do you think your efforts did not achieve the desired outcome?

8. Conceptual learning: why? • Faculty report spending most of their time supervising students in hands-on procedures, leaving little time focused on fostering the development of clinical reasoning skills. (Ironside, McNelis, 2009)

9. Preparation of Graduates The Advisory Board - Survey Question “Overall new graduate nurses are fully prepared to provide safe and effective care in a hospital setting.” Level of agreement among respondents (The Advisory Board, 2008)

10. Useable knowledge is organized around important concepts and the contexts in which the are applicable. (Erickson and Lanning, 2014) Pain Infection Mobility

11. The optimal way to learn is reciprocally or spirally between practice and content. (Bass, R. 2012)

12. Traditional Teaching and Learning • Encourages memorization • Often fails to promote desired outcome • Higher level conceptual thinking • Recognizing patterns and connections • Deep understanding • Organizing information into meaningful mental structures • Transfer of knowledge through time and across situations • Applying understanding to new situations (Erickson & Lanning, 2014) • Limits student engagement and motivation

13. Learning – an active, social process • Learning involves a social process of constructing meaning. • The role of educators • Organize for learning rather than plan for teaching • Focus on what students will do to learn and what the educator will do to inspire and support learning (Gagnon & Collay, 2006)

14. Results of Conceptual Learning • Development of structures in the brain to reflect, sort and organize information and construct personal meaning by applying new learning • Motivation for learning through intellectual engagement • Use of knowledge and information across time and situations

15. Conceptual Learning: how? • Students review assigned material before class • Use class time to apply new information to existing knowledge • Apply concepts to clinical situations to develop deep understanding • Students learn how to create new knowledge that is salient and contextual

16. Discuss concepts situated in their naturally occurring state rather than as individual beads on a string. (Benner, 2012)

17. The careful selection of content, including concepts, and strategies for experiential learning and situated thinking are required for students to learn to think and act like a nurse.(Benner, 2013)

18. Impact of Instructional Strategies Level of Impact (Erickson and Lanning, 2014)

19. Creating Learning activities • Develop relevant, challenging learning activities that are aligned with learning goals • Carefully selected activities to promote deep understanding • Activities at the student’s level, increase curiosity and motivation (Erickson & Lanning, 2014) • Provide opportunities to learn • Engage students in rich learning activities 70% of class time (Erickson & Lanning, 2014)

20. Learning • Constructivist Learning Theory • An active process in which learners construct new meaning based upon their past and current knowledge, and share information with each other and the instructor. • Active Learning • A process in which student learn by being engaged in and take responsibility for their own learning.

21. Concepts and clinical situations • Healthy function related to concept • Relationship of clinical situation and concept • Clinical condition • History, age and developmental stage • Alteration in anatomy and physiology • Patient care • Physical assessment • Laboratory and diagnostic tests • Nursing actions • Medication, Diet, Activity, Treatments • Patient and family concerns • Teamwork and collaboration

22. Oxygenation: Pulmonary embolism Age: 72 year old female Developmental Stage: Integrity v.s. Despair • History: Pre-existing health condition(s), History • Alterations in anatomy and physiology: Ventilation-perfusion • Patient care • Vital Signs, Lung Sounds, O2 Sat, level of consciousness, mental status • ABG’s, CBC, D-dimer, Chest x-ray, Pulmonary Angiography • Streptokinase, Heparin, Oxygen, IV access • High Fowler’s position, 2gram Na Diet • Patient/family concerns • Surgical insertion of Vena Cava Filter • Teamwork and Collaboration • Pulmonology, Surgery, Respiratory Therapy, Radiology. Laboratory

23. Evolve clinical situation over time Scenario: The acute condition is resolving and preparations are needed for the patient’s upcoming discharge. • Patient education • No smoking • Wear support stockings • Do not cross legs, stand or walk 5 minutes every hour during day, active ROM exercises when sitting, short walks several times a day • 2 gram Na Diet, Limit intake of foods high in vitamin K • Warfarin • Avoid aspirin products unless prescribed by healthcare provider • Use electric shaver and soft-bristled toothbrush • Adhere to scheduled laboratory appointments to check PT and INR • Discharge planning: Home Health Services, medical equipment

24. prepare educators • Identify and assign concepts and related clinical situations to courses • Discuss concepts in relation to a clinical situation • Students do not have the same sense of salience as instructors • Ask questions to help students verbalize their thinking and to evaluate their understanding • What information in the situation is related to the concept? • What information is most important? • What actions should be taken? Why? • Provide feedback and redirect as necessary

25. Learning Activity Examples

26. Learning Activity Examples

27. Set Student expectations • Clearly communicate your expectations • Prepare students for their role • Support students in the transition to conceptual learning • Anticipate and prepare for resistance • Be consistent with expectations

28. Conceptual Learning Activity checklist • Activity is related to course objectives • Activity relates concept to a clinical situation • Activity promotes deep understanding • Activity is appropriate for knowledge level of students • Instructor feedback is incorporated in the activity • Percent of class time engaging in conceptual learning activities is at or approaching 70%

29. Group Activity • Select a concept that you would like to help students gain a deep understanding of. • Describe a clinical situation that can be used to facilitate conceptual learning • Identify a learning activity that would help students develop a deep understanding of the concept and clinical situation.

30. Students learn when they build connections between prior knowledge and new information. Educators can engage students in learning, by helping them apply concepts to clinical situations and develop deep understanding.

31. References Bass, R., (2012) “Disrupting ourselves: The problem of learning in higher education.” Educause Review, March/April, 2012 Benner, P. (2012). Situating concepts and competencies in nursing education, research and practice. Educating Nurses, September 12, 2012. Benner, P. (2013). Re-conceptualizing the Curricular and Pedagogical Uses of Concepts in Nursing Education. Educating Nurses, March 26, 2013. Benner, P., Sutphen, M., Leonard, V., Day, L. (2010). Educating nurses: A call for radical transformation. San Francisco, CA: Jossey-Bass. Erickson, H. L., & Lanning, L. A., (2014). Transitioning to concept-based curriculum and instruction: How to bring content and process together. Thousand Oaks, CA: A SAGE Company.

32. References Gagnon, G. W., & Collay, M. (2006). Constructivist learning design. Thousand Oaks, CA: A SAGE Company. Giddens, J. F. (2013). Concepts for nursing practice. St. Louis, MO: Elsevier. Ironside, P., McNelis, A. (2010). Clinical education in prelicensure nursing programs: Results from a 2009 NLN National Survey. New York: National League for Nursing. McDonald, K., Smith, C.M., Billings, M., Kowalski, K. (2013) The flipped classroom for professional development: Part 1benefits and strategies. Journal of Continuing Education, 44(10), 437-8.