Progressive Transformational Teaching

Discussion board post for NURS624 Teaching in Health Disciplines, posted on May 8 2023. Post is in response to colleague discussing their behaviorist teaching approach.

My teaching perspective differs from yours, in that it is a progressive humanist approach, with a transformational learning theoretical underpinning. A progressive perspective centers around problem-solving based learning, encouraging learners to actively participate in their learning environment, learn through experiences and collaboration with their teacher and others learners alike (Melorse, Park, & Perry, 2021). With the added humanist perspective, the idea is that this type of learning will be self-directed and self-motivated by learners, with teachers serving as facilitator to the learner's self-actualization (Melorse, Park, & Perry, 2021). The transformational learning theoretical underpinning emphasizes the importance of growth through critical reflection to bridge the practice-to-theory gap, broaden or change the learner's perspective by moving beyond factual knowledge to critical analysis and creation of knowledge (Melorse, Park, & Perry, 2021).

In contrast to a behaviorist approach, evaluating students from a progressive, transformational lens is more difficult and nuanced, due to the individuality of learners and less specific criteria or structure of knowledge assessment. However, in my clinical teaching practice, I overcome this challenge by focusing on establishing connections and building rapport with my students; this allows me to evaluate them informally on an ongoing, continuous basis, and identify moments of growth or transformation. It also allows me to provide frequent feedback, and (most importantly, in my opinion) apply a scaffolding approach to teaching.

Evidence supports scaffolding questions as a teaching method for promoting higher-level learning in students (Seibert, 2022). Per Bloom's taxonomy, lower-level learning involves remembering and understanding concepts, and applying them; higher-level learning involves analysis and evaluation of knowledge, and eventually the creation of knowledge at the highest level (Bloom, 1956). Theory courses can prepare and evaluate nursing students at the lower-level categories, but it is clinical teaching that addresses higher-level learning. When students are immersed in the clinical environment, analyzing patient conditions, communication and interdisciplinary care delivery, rationalizing and evaluating their interventions, and ultimately creating their own care plans or innovative ideas for care delivery/patient management -- that is when students are engaging in higher-level learning. If the students do not readily know the answer to higher-level thinking questions (which is typically the case), we collaboratively work through the process/steps of Bloom's taxonomy to logically arrive to an answer or to a way to seek necessary information to arrive to the answer. It is this process that students need to learn, so that they can apply it to any clinical situation that may arise.

Clinical teachers, then, have a critical role in facilitating this type of learning through the type of questions they ask students. Scaffolding questions is a means of coaching students progressively through the levels of learning, so that they essentially develop the ability to 'think like a nurse'. Two methods have been highlighted as ways for clinical teachers to implement scaffolding questions. The first method is by approaching a student to determine their level of knowledge about specific diseases, treatments, interventions, etc. and asking sequentially building questions that work through the different levels of Bloom's taxonomy. The second method is by responding to a student's question with another question that will facilitate their ability to think in a particular way, rather than simply providing an answer and halting their learning (Seibert, 2022).

I have been using both approaches throughout my clinical teaching practice, with significant levels of success. I have had graduated students reach out to tell me they still remember the kind of critical thinking questions to ask themselves that I taught them years before, and that they use these approaches constantly in their nursing practice. In fact, at the onset of a clinical semester, I tell all of my students that I will be constantly asking them critical thinking questions, not for evaluation or even with the expectation that they will have an answer; but, rather, to teach them what kind of questions they should be asking themselves. I warn them of this ahead of time, and reassure them of my expectations of responses (or lack thereof), which I think is a significant step that is often overlooked by teachers, because I do not want them to develop anxiety about my questioning. Undue anxiety in students hinders learning and does not foster a sense of excitement and curiosity for learning, which is what I am trying to help them develop.

Scaffolding questions is a practical, and highly effective method for guiding learners through the levels of Bloom's taxonomy, giving them a stairway to higher-level thinking. If students are taught with this scaffolded approach, they will learn the path up the stairs, so they can eventually take those steps independently for any topic or learning need that arises for them.

References

Bloom, B. (1956). Taxonomy of educational objectives, handbook I: The cognitive domain. New York: David McKay Co Inc.

Melrose, S., Park, C., & Perry, B. (2021). Creative clinical teaching in the health professions. Athabasca, AB, Canada: AU Press.

Seibert, S. A. (2022). Scaffolding questions to foster higher order thinking. Teaching and Learning in Nursing 18(2023): 185-187. https://doi.org/10.1016/j.teln.2022.09.008