The Journal of Continuing Education in Nursing

Original Article 

Faculty as Active Learners About Their Practice: Toward Innovation and Change in Nursing Education

Ana Cabral, PhD; Ana Baptista, PhD

Abstract

This article describes the perceptions of a small group of nursing education faculty members participating in the continuing professional development module, Pedagogy in Higher Education, regarding the use of active learning strategies. Data were collected using field notes and participants' presentations and articles about their experiences when using innovative teaching strategies. The findings point out the benefits for knowledge mobilization, the development of synergies based on collaboration, and other gains in terms of students' experiences. Challenges involve the use of these active strategies on a regular basis as part of a sustained and aligned approach to enhance teaching and learning. [J Contin Educ Nurs. 2019;50(3):134–140.]

Abstract

This article describes the perceptions of a small group of nursing education faculty members participating in the continuing professional development module, Pedagogy in Higher Education, regarding the use of active learning strategies. Data were collected using field notes and participants' presentations and articles about their experiences when using innovative teaching strategies. The findings point out the benefits for knowledge mobilization, the development of synergies based on collaboration, and other gains in terms of students' experiences. Challenges involve the use of these active strategies on a regular basis as part of a sustained and aligned approach to enhance teaching and learning. [J Contin Educ Nurs. 2019;50(3):134–140.]

It is the responsibility of higher education institutions, in their mission, and of faculty members, in their practice, to generate and consolidate high-level skills in their students. Thus, teaching and learning should foster the active involvement of students in their own learning process with the faculty members playing an essential role in mediating such processes, facilitating and moderating those contexts.

In nursing education, the use and reflection about the effectiveness of active learning has included problem-based learning approaches (Bailey, 2017; Beers, 2005), peer coaching and mentorship (Andersen & Watkins, 2018; Badowski & Oosterhouse, 2017), role-playing and simulation (Stanley, Serratos, Matthew, Fernandez, & Dang, 2018; Young, 2018), the development of critical thinking skills (Newton & Moore, 2013; Nguyen-Truong, Davis, Spencer, Rasmor, & Dekker, 2018), clinical reasoning and judgment (Lee & Bagnardi, 2016), the use of research for the development of an evidence-based practice (Wonder, Spurlock, & Ironside, 2016), and curricular changes using technology (Holman & Hanson, 2016; Jackson, 2017). Nevertheless, Waltz, Jenkins, and Han (2014) identified major gaps and insufficient evidence regarding the calling for the development of high-quality research to build an evidence base supporting the use of these methods. Issues involve resistance by students and faculty to get involved in active learning (Walters, 2014), difficulties in building more collaborative teacher–student relationships (Millis & Cottell, 1998), and coping with the uncertainty of experimenting and using different strategies (Paige & Smith, 2013). Overall, the literature has identified the need for the development of supported curriculum changes to foster innovation and help to overcome more demanding students' needs (Biggs & Tang, 2011; Fater, 2013).

The use of active strategies implies the development of the reflective capacity in relation to practice (Moon, 2005), teaching and learning contexts (Biggs & Tang, 2011), the relationship between students and faculty members (Barnett, 2007), and factors associated with academic knowledge (Murray, 2008; Walters, 2014). Therefore, faculty should reflect on practice focusing on an active search for strategies and approaches that include, among others, (a) collecting data (evidence) about practice to build portfolios (e.g., resources, strategies, materials); (b) using critical friends to observe the practice (e.g., peers of the institution); (c) getting feedback from students (e.g., comments, suggestions, perceptions); (d) participating in networking activities and interacting with peers; and (e) collaborating in reflection and intervention groups or communities of practice (Moon, 2005). In addition, faculty should be prepared to analyze, experiment, and evaluate innovative teaching–learning approaches (Biggs & Tang, 2011).

This article aims to answer the question: How do faculty members perceive the use of active learning strategies in their teaching? The authors followed a descriptive and reflective narrative based on the teaching experiences of a group of nursing education faculty members within a continuing professional development (CPD) module aimed at improving their own teaching practices.

The Context

The CPD module, Pedagogy in Higher Education: Strategies for Innovative Teaching, Learning, and Assessment, intended to promote a reflection on pedagogical practices and strategies, as well as a discussion of the outcomes of an interactive training task based on the implementation of an active pedagogical strategy in the context of classroom practice. This module was accredited by the pedagogical and scientific committee of the University of Aveiro (Portugal). The module was run by one academic developer (A.B.), and was directed to faculty members from different disciplines, institutions, and levels of experience. A total of 10 faculty members voluntarily participated, but this article reports on the practices of the five nursing education faculty members, all female and experienced but at different stages of their career. Throughout the CPD sessions, the participants explored and were led to reflect on a wide variety of active teaching–learning strategies. Each faculty member was invited to undertake a small study in the context of their practice, as part of the CPD module. They used one strategy and reported on the pedagogical experience as an oral presentation to the group at the last session of the module and submitted a short article for publication.

The Study

The current study employed a qualitative design aiming to explore the views of five (female and experienced) faculty members regarding the active strategies they had employed in the context of their teaching practice (Corbin & Strauss, 2008).

Data were collected using field notes from the observation of the module sessions (40 hours of training) and presentations and articles written by the faculty members. These articles contained information about faculty's reflections on the experience and their perceptions about students' development. To gather information about students' reactions to the strategy, each faculty member developed and validated their own data collection tools—usually a questionnaire with closed and open answers.

Participants provided verbal informed consent and were reassured of their right to withdraw at any time. Participants' identities were protected by pseudonyms during data analysis.

Deductive thematic analysis was performed by one of the researchers (A.C.) and then reviewed by the other researcher (A.B.). An analytical framework was developed to portray faculty members' perceptions of the use of active learning strategies in their teaching (the question of this article: How do faculty members perceive the use of active learning strategies in their teaching?). Therefore, the framework included the following themes: (a) identification of the active learning strategy, (b) its definition according to the literature, (c) aim of each faculty member to use the strategy, (d) description reported by each faculty member of the pedagogical approach, particularly related to students' reactions and engagement, (e) reflection on the use of the strategy, and (f) levels of complexity of each strategy.

The participants' answers described their individual views as key informants; according to Payne and Payne (2004), “those whose social positions in a research setting give them specialist knowledge about other people, processes or happenings that is more extensive, detailed or privileged than ordinary people” (p. 134).

The Cases

The findings of our study were organized in cases and followed the structure of the thematic analysis described above. Relating to the latter theme, the five cases can be presented following a spectrum of cumulative levels of complexity:

  • Revision + consolidation (think-pair-share).
  • Revision + consolidation + practice (cooperative problem solving).
  • Revision + consolidation + practice + self-awareness and reflection (role-play).
  • Revision + consolidation + practice + self-awareness and reflection + awareness and reflection about a peer's actions (mirroring technique and peer coaching).

This section is structured from the least to the most complex strategies. The readers will thus be able to replicate these strategies in their practice, depending on their own teaching repertoire.

Case 1: Think-Pair-Share

Think-Pair-Share (TPS) envisages three interrelated steps (Azlina, 2010; Kothiyal, Majumdar, Murthy, & Iyer, 2013):

  • Think individually: the student needs to reflect on a question problem individually, while also doing it pro-actively, by presenting a solution and/or taking a position.
  • Pair: requires the students to think and discuss in pairs chosen by the teacher. Students discuss their opinions and solutions with each other, while listening carefully, and need to reach a consensus about their positioning and/or solution.
  • Share: opens the possibility to each pair to present their perspectives to the whole or bigger group.

The faculty member used TPS in a practical session with 22 students enrolled in the third year of their nursing program. It was highlighted that the aim for using the strategy was to revise key concepts and contents, by debating and solving small focused problems, adopting a critical stance while developing social and communicative skills.

The faculty member reported an active and meaningful involvement from students on the tasks. The intention of promoting social skills and collaboration among students, through significant sharing and conversations to reach a consensus, was achieved. Throughout this process, students demonstrated the development of their reflective positioning given that they needed to critically approach the questions presented by the faculty member. In fact, future nurses need to show metareflection and critical thinking when approaching theoretical issues so they can make the best conscious decisions in their professional practice (Huang, Lin, Ho, Chang, & Chen, 2015; Kaddoura, 2013; Thaman, Dhillon, Saggar, Gupta, & Kaur, 2013). In addition, students had the opportunity to develop synthesis skills and practice oral presentation skills, although in an informal climate. Pair support was considered to help the students to develop high-quality responses in terms of arguments, ideas and content, and their self-confidence, which is also important in a future health professional (Huang et al., 2015; Kaddoura, 2013; Thaman et al., 2013).

When using a questionnaire at the end of the session where TPS was put into practice for the first time, students highlighted some positive aspects, particularly the involvement of everyone in the discussion, and the sharing process among themselves. Students also stressed that they felt more motivated toward learning. The faculty member considered herself to be more confident in applying this and other active teaching–learning strategies because of the gains in terms of structured participation from students, ability to synthesize, and consolidation of disciplinary content.

Case 2: Cooperative Problem Solving

Cooperative problem solving merges cooperative learning and problem solving. Groups of students need to work together by following the rules of cooperative learning: positive interdependence, individual accountability, face-to-face interaction, appropriate use of social skills, and self-assessment (Felder & Brent, 1994). All students need to be responsible for the quality of the work, which is a common objective. Two problems based on real life were presented to the students who should solve them cooperatively and reach a consensus (Savery, 2006), which afterward was presented and discussed in the bigger group.

The faculty member used this strategy in a practical session with 20 students enrolled in the third year of their nursing program. Cooperative problem solving aimed at creating an environment that would allow students to face problems, which would potentially be similar to those usually encountered in the workplace, by developing their social and communicative skills and, primarily, critical thinking.

When using cooperative problem solving, the faculty member observed that students used interpersonal skills and needed to work in teams to reach a common goal. Metareflection and critical thinking while articulating disciplinary knowledge were mobilized to solve real-life problems. Students discussed problems by revising and consolidating previous knowledge while adopting a critical perspective. In addition, students were asked to go further in their collaborative thinking by solving newly devised problems. By having different roles within the group, students were deeply involved in the tasks and in reaching a solution for the problems.

At the end of the session, students completed a questionnaire to report on the newly used strategy. They emphasized increased motivation, ownership, and accountability to complete the task. Also, the sharing process within the cooperative work to reach consensus was important to broaden their perspectives and approaches to (solving) problems. When reflecting on the process, the faculty member considered the need of continuing to use teaching–learning strategies that have closer links to what the students, future nurses, will be facing in their professional context (Waterkemper & Prado, 2011). She considered this to be an opportunity to enrich students' experiences.

Case 3: Role-Play Based on a Real-Life Situation

Role-play asks for students' involvement with different roles and profiles, participating and interacting with somewhat complex scenarios. These scenarios are designed to promote learning, while enhancing reflective practice and requiring guided and prompt feedback (Ertmer et al., 2010). Reflection should always coexist after the actual simulation and debriefing (Prion, 2008). Therefore, roles and tasks are given to whomever is participating in the simulation and who is observing.

This strategy was operationalized in three practical sessions within a first-year module of the nursing program. Thirty-seven students participated. The faculty member aimed at promoting the development of students' technical and scientific skills, social and communicative skills, as well as self-confidence and critical thinking. Role-play based on a real-life situation stimulated revision and consolidation of previous acquired knowledge, reflection, and conscious actions to solve a problem presented to the students.

The faculty member observed students' enthusiasm and motivation. Students were responsible and aware of their roles as actors and observers. The observers were asked to pay particular attention to the real-life scene so they could provide enriching and reflective feedback (Prion, 2008). The strategy demonstrated to be suitable to enhance both social and intrapersonal skills, such as respect and self-confidence (Mooradian, 2008). By practicing real-life situations within the classroom and in a safe learning environment, the faculty member tried to reduce potential stressful situations related to the students' future professional life. Simultaneously, technical and disciplinary-specific skills alongside critical and metareflective thinking were enhanced by working with practice-based situations (Chau et al., 2001; Mooradian, 2008; Prion, 2008).

In the final questionnaire, students reported the following:

  • The improvement of technical procedures, as well as communicative skills.
  • A more evident awareness of the mistakes that occurred, particularly because theory and practice were integrated.
  • The deconstruction of situations that could cause some fear among students as future practitioners.

Finally, the faculty member highlighted that she felt more able to interact with students. This was seen as a moment to self-reflect on her own practice as a teacher.

Case 4: Mirroring Technique

Mirroring is a simulation technique where a systematic reflective practice about the practice or action is the main element that facilitates the learning process (Ferreira, 2001). It was introduced and developed in a higher education clinical context in 1999 by a Portuguese academic (Ferreira, 2007). Students practice nursing techniques in pairs: one student executes the procedure, while the other observes and takes notes. After executing the procedure, they move to a neutral environment. The student who did the procedure makes a detailed description. The student who was observing reports back what he or she saw, without judging the colleague, and highlights the strengths and the steps that need to be improved. The teacher mediates the conversation until the students understand and feel comfortable with the technique.

The faculty member designed a practical session with 14 students enrolled in the first year of their nursing program and aimed at practicing different procedures and techniques within a controlled environment. Students were asked to revise, consolidate, and practice already known procedures but, above all, to reflect on their own practice as well as their colleague's.

The mirroring technique allowed students to engage in a systematic reflective process on action, making them explicitly aware of their strengths, weaknesses, and ways of improving their learning (Ferreira, 2007; Santos, 2009). It allowed time and space for students to think together and be more demanding with their own practice by acknowledging what still needed to be improved (Potter, Perry, Stockert, & Hall, 2016). Also, the faculty member understood the potential of this technique in terms of the promotion of students' (future professionals') self-esteem and confidence alongside technical procedures (Ferreira, 2001, 2007).

By completing a questionnaire, students reported on the gains related to knowledge consolidation by identifying and overcoming errors. Students also recognized that teaching–learning processes were enhanced by learning from and with their peers given that they needed to help and listen to each other. The faculty member stressed the importance of choreographing the pedagogical practice so this could be sustainable and relevant to the students.

Case 5: Reinvented Peer Coaching

Peer coaching (Parker, Hall, & Kram, 2008) was somewhat reinvented in the context described by this faculty member. This was applied in the classroom by partnering an expert student—in this case a student almost completing the nursing degree—with the teacher.

The faculty member aimed at developing an innovative practical session where the students were at the center of the teaching–learning process by having an expert (third-year) student teach a specific topic to 14 younger colleagues enrolled in the first year. This is supported on the creation and promotion of communities of practice, where students care and learn from each other (Parker et al., 2008).

This strategy allowed the development of a pedagogical partnership between the expert student and the faculty member, who guided the student to prepare the teaching session, and between the expert student and the fellow beginners. The expert student had already demonstrated theoretical and practical knowledge and skills of the topic that was chosen for a specific teaching session. After having prepared the session and gone through it with the teacher, the expert student taught nonexpert students, who were beginning their higher education. The expert student reinforced his or her own knowledge while passing it on to colleagues by being a facilitator of their learning. Therefore, this strategy encouraged the development of trust between the expert student and the faculty member, as well as between the expert student and colleagues (Carlile & Jordan, 2005).

After the session, by completing a questionnaire, the expert student highlighted that several skills were developed throughout the process: communicative, technical, and academic, as well as metareflective, namely about the learning process. Having the opportunity to teach their peers, their own learning process on theory and practice was optimized. The beginners reported that they felt a connection with the expert fellow student. They considered the discussion and lecture to be really interesting and clear, and they felt more at ease to ask questions and share experiences. The faculty member concluded that teaching–learning became richer and intrinsically more interactive and motivating, while also giving the students a different insight into the process, due to the cocreation of the teaching session.

Bringing the Cases Together

Revisiting our initial question (How do faculty members perceive the use of active learning strategies in their teaching?) and bringing the cases together lead us to highlight that:

  • All active teaching–learning strategies mobilized diverse skills from students.
  • All students recognized the benefits and gains added by each strategy to their path as learners and future professionals.
  • Faculty members were facilitators of students' learning experiences.
  • There was a wide acknowledgement of teaching–learning synergies based on joint responsibilities (student-to-student, and student-to-faculty member).
  • Students and faculty members reflected on their learning processes.

There was intentionality from the faculty members to choose a different teaching–learning strategy from those already in use in their pedagogical repertoire. This led to a metareflective process when reporting on the experience. This was promoted by their participation in the CPD module: they got involved in discussions about teaching–learning practices, they questioned the effectiveness of the approach and strategies used, and they tried something within their own classrooms. Simultaneously, they had the opportunity to engage in a reflective cycle, by collecting and discussing data from students, developing strategies to overcome preconceptions, and creating opportunities toward innovation and change. Throughout this process and by refining and consolidating intuitive teaching–learning practices, faculty members explored possibilities by tailoring strategies to specific contexts. Also, this boosted their self-confidence and self-awareness related to their teaching–learning contexts, opportunities, and paths. We can thus see faculty members as learners. Whatever fears they might have had, these seem to be overcome by the narratives that were shared. However, a challenge remains: will the faculty members integrate these and other active learning strategies in their pedagogical repertoires and find a way to make them sustainable and aligned throughout students' experience of their course degree?

Conclusion

This study found that faculty members involved in nursing education gained from participating in the CPD module and exploring the potential of newly devised active teaching–learning strategies used in their classrooms. The cases showcase different approaches that can be replicated in other contexts within nursing education. This study reinforces the need for investment in tailored CPD developmental opportunities that allow faculty to expand their knowledge around theory, practice, and praxis so they can make informed evidence-based decisions involving planning toward educational quality enhancement within the classroom. The case studies emphasize that explicit awareness of teaching–learning strategies (nature, implications, and outcomes) leads to the development of faculty's self-confidence to take some risks and tailor practices to contexts. We have witnessed that authentic collaboration between students and faculty members can be achieved through intentional, meaningful, and rewarding opportunities.

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Authors

Dr. Cabral is Learning Development Advisor, and Dr. Baptista is Learning and Teaching Advisor, Learning Development, Academic Development, Student and Academic Services, Queen Mary University of London, London, United Kingdom.

The authors have disclosed no potential conflicts of interest, financial or otherwise.

Address correspondence to Ana Cabral, PhD, Learning Development Advisor, Learning Development, Academic Development, Student and Academic Services, Queen Mary University of London, Mile End Road, London E1 4NS, United Kingdom; e-mail: a.baptista@qmul.ac.uk.

Received: June 01, 2018
Accepted: October 22, 2018

10.3928/00220124-20190218-09

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