Passing on power & voice: Reflecting an alternative educational model in nursing education

Presenting Author: Røn Noer, Vibeke; Sand Nielsen, Cathrine This paper reflects experimental teaching strategies and learning outcome as performed and evaluated in an experimental educational model in the Nursing Education in Denmark. The Danish nursing education is a general education. The education lasts for 3,5 years and the landmark of the educational model is the continuously shifts between teaching in classroom and teaching in clinical practice. Clinical teaching takes place at approved clinical placement institutions in hospitals and in the social and health care services outside hospitals. The nursing programme corresponds to 210 ECTS of which 90 ECTS cover clinical teaching. The class evaluated, is a class following an alternative educational model at The School of Nursing in Aarhus. The class was enrolled in 2009 and the purpose was to educate more nurses – with the secondary intention of gaining knowledge about other possible ways to perform the education. The class, named the E-class, followed what in the field was named ‘an experimental educational model based on experienced-based learning’ (Nielsen et al. 2011). The experiential educational model is argued as an experiment primarily based on two principles: (1) studies in clinical settings always preceded classroom teaching (“practice-before-theory”) and (2) time spent where students, clinical instructors as well as lecturers from the school is present was increased (“the recurrent pedagogical concept”) (Røn Noer, 2014, in press). The class graduated January 2013. Over the past decades, the Nursing Education has undergone substantial changes in content as well as organizational changes. One of the major changes has been the integration of nursing programmes into higher education institutions, which in Europe includes Universities, University Colleges and Higher Professional Colleges. In spite of the changes, the literature still suggests the need for radical transformation within the nursing education – and point to the overall vision of transforming the education in order to strengthen and connect education and health care systems (Benner et al, 2010; Garret, 2012). The E-class was an attempt to develop and evaluate an alternative educational model, and in this sense the E-class offers experiences with other possible ways of educating nurses. The purpose of this paper is not to evaluate the experimental model as a whole, but to reflect one of the chosen teaching strategies used in the nursing course ‘Acute, Critical Nursing & Terminal, Palliative Care’. For full evaluation of the alternative educational model, see [in dansh]: http://www.viauc.dk/sygeplejerske/aarhus/forskning-og-udvikling/Sider/E-klasse%20projekt.aspx Higher degree of student involvement in planning as well as teaching was in the field presented as a part of ‘the overall educational approach’. In the course ‘Acute, Critical Nursing & Terminal, Palliative Care’ this was transferred into an innovative pedagogy with intend to pass on power and voice to the students by letting the students be responsible for a greater part of teaching in the classroom. In that sense the teaching strategy can be seen as reversing the teacher-student role. The choice of letting the students take on a greater responsibility for the actual teaching was based on the assumption that this would positively affect their learning outcome (Nordenbo, 2008; Hedegaard og Jespersen 2011), and their ability to transfer their knowledge into value for fellow students (Kirketerp 2012). This paper will reflect the strategy and discuss the following two research questions: (1) What happened when power and voice in the classroom was transferred to the nursing students? And (2) What possible consequences can be seen regarding roles of the teacher and the student? Methodology, Methods, Research Instruments or Sources Used: Mapping out the field, educational ethnography give voice to those involved in learning and teaching in diverse learning spaces and time (Hammersley and Atkinson 2007; Borgnakke 1996ab). This paper reflects teaching strategies and possible learning outcome in the classroom in the 3. Year of The Alternative Educational Model. Both authors have been part of the E-class as teachers, and this paper is to be considered as a Self-evaluation (in Danish: Selvevaluering) (Dahler-Larsen, 2003). In that sense it is a critique and retrospective view on the choice of teaching strategies, the ideas, content and results (Borgnakke, 2008). Data is generated using a combination of field notes and video. Complementary data consist of the students’ own choice of literature, both teachers own evaluation of the course as a whole, and the official documents of that course (VIA UC 2011abc). In the course ‘Acute, Critical Nursing & Terminal, Palliative Care’ the class was divided into 6 groups. This paper reflects one of the group performances’. As the choice of reversing the roles was a major characteristics of the course this was chosen as the analytical object (Borgnakke, 1996ab), and the offspring of the analysis take on the pivotal moments in the teaching actual given, and can best be described in following headlines: “The space of death, going in and out”, “Conquering the classroom”, “(Sorry!) Who’s to talk now?”, “Dear Ophra”, “They came, they taught – they were victorious”. Conclusions, Expected Outcomes or Findings: The students observed did perform outstanding. They were well prepared, innovative in their choice of teaching strategies, inclusive of fellow students and in a profession oriented as well as pedagogical point of view highly proficient. Focusing on real student experienced dilemmas related to ‘Death and dying’, the class takes on the responsibility actively to discuss dilemmas inherent in the nursing profession. The reversed roles of the student and the teachers could be argued to transfer not only voice, but also power to the students. Power used to reflect and combine knowledge and skilled know-how experienced and practiced in clinical learning contexts, but put into words and reflected in the classroom. One could ask if the performance of the group observed was impacted by the alternative teaching strategy, or simply based on talent of the observed group members? We will state that the learning strategy put up a frame for the student to work within, but it was primarily a group victory – they took on the responsibility, they had the capacity to do so – and they dared to! Evaluated by their own classmates in words of: “workable, meaningful teaching, a capacity to make the complex look simple, inspiring, interesting, inclusive” (Video, January 2012). In many ways wishful evaluations for any one with intend to pass on knowledge and to create space for reflection in the profession. Passing on power and voice in this sense was empowering! This paper will reflect the strategy of reversing roles in the classroom and bringing real clinical experienced dilemmas into the classroom. In doing so contributing to the ongoing debate about bridging the gap between clinical and classroom teaching in The Nursing Education. References Benner, Patricia E., Molly Sutphen, Victoria Leonard, and Lisa Day. 2010. Educating nurses: A call for radical transformation. 1.ed. San Francisco: Jossey-Bass. Borgnakke, Karen. 1996a. Procesanalytisk teori og metode. bd.2: Procesanalytisk metodologi. [S.l.]: Thesis. Borgnakke, Karen. 1996b. Procesanalytisk teori og metode. bind 1: Pædagogisk feltforskning og procesanalytisk kortlægning: En forskningsberetning. [S.l.]: Thesis. Borgnakke K. 2008 ’Evalueringsstrategier – i den pædagogiske kontekst’ I: Evalueringens spændingsfelter, redaktør K. Borgnakke, 1. udgave, Klim, Aarhus, s. 9-66. Dahler-Larsen P. 2003 Selvevalueringens hvide sejl. 1. udgave, Syddansk Universitetsforlag, Odense Garrett, BM 2012 Changing the game; some thougths on furture demands, techonology, nursing and interprofessional education. Nurse Education in Practice 12(4):179-181 Hedegaard, KM & Jespersen, KK. 2011 ’Didaktiske kategorier og udfordringer’ I: Professionsdidaktik – grundlag for undervisning i professionsrettet uddannelse, redaktører KM Hedegaard & K. Krogh-Jespersen, 1. Udgave, Aarhus N, Klim, s. 87-110. Kirketerp, AL. 2012 ”Foretagsomhedspædagogik og SKUB-metoden”, Kognition og pædagogik, årg. 22, nr. 83, s. 66-86 Nielsen, Carsten and others. 2011 "Projektevaluering 1. Studieår, Ekstra Klasse 092E" VIA University College, Sygeplejerskeuddannelsen i Aarhus, Aarhus. Noer, VR 2014 ”Zooming in - Zooming out - using iPad video diaries in ethnographic educational research” (In Press). Nordenbo SE, Søgaard Larsen, M., Tiftikci, N., Wendt, R.E., & Østergaard, S. 2008 Lærerkompetencer og elevers læring i førskole og skole - Et systematisk review udført for Kunnskapsdepartementet, Oslo. Dansk Clearinghouse for Uddannelsesforskning, DPU. Lokaliseret den 20.10 2013 på: http://odense.dk/~/media/SUBSITES OG WEBLIGHT/SUBSITES/DSS/PDF-filer/Lrerkompetencer og elevers lring i frskole og skole.ashx VIA UC 2011a, Modulbeskrivelse - Modul 10 (efteråret 2011), Sundhedsfaglig Højskole Sygeplejerskeuddannelsen i Århus E-klassen. Lokaliseret 07.01. 2014 på: http://www.viauc.dk/sygeplejerske/aarhus/forskning-og-udvikling/Documents/Uddannelsesdokumenter E-klassen/09IIE_M10_Modulbeskrivelse.pdf VIA UC 2011b, Opgavekriterier Modul 10, gældende for 09llE, casearbejde, Sundhedsfaglig Højskole Sygeplejerskeuddannelsen i Århus. Lokaliseret 07.01. 2014 på: http://www.viauc.dk/sygeplejerske/aarhus/forskning-og-udvikling/Documents/Uddannelsesdokumenter E-klassen/Opgavekriterier/09IIE_M10_casearbejde.pdf VIA UC 2011c, Prøvekriterier Modul 10. Gældende for 09llE”, Sundhedsfaglig Højskole, Sygeplejerskeuddannelsen i Århus. Lokaliseret 07.01. 2014 på: http://www.viauc.dk/sygeplejerske/aarhus/forskning-og-udvikling/Documents/Uddannelsesdokumenter%20E-klassen/09IIE_M10_Proevekriterier.pdf Intent of Publication The full paper 'Passing on Power & Voice' is in press in the upcoming Anthology reflecting and evaluating The Alternative Educational Model (Expected, Spring, 2014).