Learners’ Needs and Practice-Based Learning Informing Tertiary Teaching

This project provides a foundation from which to develop innovative teaching and learning materials to address the practice-based learning needs identified. Primary contact person for project - Dr Philippa Seaton, School of Nursing and Human Services, Christchurch Polytechnic Institute of Technology (CPIT). For a copy of the full report please contact Dr Philippa Seaton at seatonp@cpit.ac.nz

Philippa Seaton, Paul Watson, Jane Mountier, Deborah Sims

Executive Summary

Aims

The purpose of this project was to gather information to assist educators to actively connect teaching with workplace learning. The parameters of the project were confined to learners’ needs regarding child and youth health as that is a priority, high impact field of learning for practice nurses. This project provides a foundation from which to develop innovative teaching and learning materials to address the practice-based learning needs identified. The specific aims of the study were:

• To identify the priority educational needs of practice nurses related to child and youth health
• To describe the practice-based learning experiences of these nurses
• To determine the implications of these findings for transforming curricula and teaching practices in workplace learning.

Methods

A mixed methodology design was employed in this project. This approach consisted of three phases that were distinct, but built on each other to provide comprehensive information related to the purpose of the study. Phase 1 used a modified Delphi technique to identify and prioritise educational needs. This structured process is designed to reach consensus among a group of experts. It consists of multiple rounds of questionnaires, each building on results from the previous questionnaire. Round one asks a question to generate ideas; following rounds are used to rank the responses received. In this project the number of rounds was limited to two. Although using a limited number of rounds, the method for determining consensus was strengthened by respondents ranking learning needs as high, medium, or low in relation to (1) relevance to practice, (2) skills and knowledge, and (3) interest in learning more. This ranking established the priority lists. This method more effectively explored the complexities of practice based learning.

Phase 2 consisted of individual interviews to determine the features of successful practice-based learning experiences. These first two phases provided foundational evidence for Phase 3, a focus group which determined the implications of those findings for transforming curricula and teaching practices for work integrated learning. The project was overseen by an Expert Advisory panel.

Participants

Participants in all phases of this study were registered nurses working in general practices (practice nurses). There was a wide range of years of practice, practice experience, and varying post-registration education within this group of nurses. Demographic information collected from the participants in round 1 of the Delphi study, and in the interviews, showed variation in the sample that meant learning needs and practice based learning experiences were gathered from a variety of practice nurses. All nurses involved in this study were currently practising (in either part time or full time capacity) and thus met the sampling criteria of being workplace based learners.

Results

Identifying learning needs is an important first step in planning workplace learning. The Delphi phase of this project identified 74 learning needs of practice nurses related to child and youth health. However, deciding how to prioritise those learning needs is a complex process that is not a matter of simply reducing a long list of learning needs into a smaller list. Educational principles suggest that the relevance of a learning need to the learner’s work, the learner’s current level of skill and knowledge in the area, and their interest in learning more are all considerations in prioritising content for workplace learning. The findings from the Delphi phase of the project demonstrate that which educational needs are given priority will depend on whether priority is given to relevance, level of skill and knowledge, interest, or some combination of the above.

Once content is prioritised attention needs to be given to methods of delivering the content. The findings of the first phase of the study reinforce the need for a range of delivery methods that address a range of learning styles. However, there is a clear preference for kinaesthetic methods of delivery which corresponds to the majority of the practice nurses preferring to learn kinaesthetically.

The interview phase was used to gain richer information about how nurses learned successfully in practice. Themes derived from the information given by the participants provided insights into the ways both novice and more experienced practice nurses learned. These themes highlighted the complexity of learning in practice and the complicated interplay of the individual nurse and systemic factors in professional practice-based learning. Information shared included successful learning experiences that can guide practice based learning, and also insights into those elements that nurses considered constrained learning and revealed the need to further consider ways to support and strengthen practice based learning. The information from this phase of the study contributed to the development of the teaching and learning recommendations.

Summary of Recommendations

The recommendations are intended to guide and support practice-based learning. The data from phases one and two included information about effective practices that were already in place; these have been included in the recommendations to share them more widely. Other recommendations are derived from data that revealed the need to further consider ways to support and strengthen practice based learning. The recommendations have been grouped into the following areas: Educational strategies; Teaching practice; Organisational supports; and Strategies for effective learning.

Educational Strategies

• Develop responsive and innovative strategic educational planning that is future-focused, responsive to changes in the health sector, and anticipates future learning needs. Courses and qualifications need to be offered at both graduate and Masters levels, and include opportunities for practice nurses to develop leadership skills.
• Promote course evaluations that inform design and delivery to ensure courses meet the learning and practice needs of nurses. Evaluating course effectiveness both at the completion of formal study, and when learning is subsequently embedded in practice, is recommended.
• Enhance industry and education providers’ collaboration in order to create courses which are relevant, appropriate, based on current best practice, and meet learners’ needs to develop both core competencies and expert knowledge.
• Recognise the importance of context in practice-based learning through courses which acknowledge differences between practices, reflect the holistic and dynamic nature of health needs, and utilise learners’ knowledge and experience. Strategies to develop and extend practice nurses’ critical thinking and decision making abilities are essential.
• Provide support for using information technology by including structured opportunities to use relevant educational technologies.

Teaching Practice

• Provide opportunities for reciprocal and collaborative learning by supporting networking with, and learning from, colleagues in learning sessions.
• Create safe learning environments so learners can challenge themselves. Course design must include strategies to explicitly extinguish, or build on, previous learning when necessary, allowing practice nurses to update their knowledge in line with current best practice evidence.
• Utilise practice nurses’ professional skills in learning sessions and include strategies for assessing the knowledge and skills of those present so the course can be adjusted to meet participants’ needs.
• Incorporate practice nurses’ preferred learning styles in education programmes – participatory, hands-on and visual learning.
• Develop skills for online learning to support greater uptake of the opportunities this provides.

Organisational Supports

• Provide support for ongoing professional development. Employers and IPAs working together can more effectively provide support and encouragement for ongoing learning. Provision of supports or incentives for learning and an effective relief system that enables practices and their nurses to plan for study leave may increase participation in study. Develop efficient systems for informing practice nurses about funding sources, and disseminating information.
• Provide support for developing communities of practice by creating multidisciplinary and collegial opportunities to network, share information, and strategize. Offer supervision and mentoring to provide positive support and strategies for developing practice.
• Provide opportunities to recognize and utilise experience by actively encouraging experienced nurses to become mentors and educators and preparing them for these roles. Acknowledging the informal learning which occurs between practice nurses will increase job satisfaction and support collegial relationships.
• Encourage online learning by providing consistent access to a computer and the internet and allowing work time for online learning.
• Develop support mechanisms for new practice nurses to gain core knowledge and competencies as defined by the needs of their particular practice.

Strategies for Effective Learning

• Assist nurses to develop and use effective learning strategies by encouraging them to acknowledge the skills and competence they bring to formal learning and to use these to make connections with existing knowledge. Participating in reciprocal relationships with other learners increases the effectiveness of the learning opportunity.
• Maximise networking opportunities both within and beyond the formal learning environment.
• Reinforce learning in the practice setting by sharing learning with colleagues, strengthening connections with existing knowledge, inspiring learning in others, and utilising opportunities to reflect on their practice.

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