Inclusion of gerontological nursing in the curriculum has recently emerged as an issue of concern to the faculty of schools of nursing. In addition to such factors as the societal attitude toward aging and the philosophical question as to whether geriatric or gerontological nursing should be a specialty,1 practical questions arise as to how to incorporate the content on care of the elderly into the curriculum and provide opportunity for clinical experience to the student. One way of handling the situation is through an independent study approach.
Independent study is a strategy used to help individual students achieve objectives in keeping with his educational goals. This strategy has been a recognized approach to education on college campuses for many years.2 Independent study, broadly defined, includes activity carried out by an individual interested in seli-developmem through learning; it may, or may not be, initiated by the learner.3 While there may be some question about the number of students that can be accommodated through the independent study approach, it can be a means of providing curricular offerings and individualized learning opportunities.
One consideration underlying the independent study strategy is the belief about how an individual learns. Jourard4 observed that the individual always and only learns for himself. He indicated that learning is a way to be in the world; the individual learns as he pursues goals and projects that have meaning for him. Tough3 noted that most individuals undertake at least one or two major learning efforts a year and some individuals undertake many more. Gange and Briggs,5 commented on the fact that, while learning is an individual matter, there are fewer opportunities for independent learning than learning in a group. They also indicated that sophisticated learners, eg, university students, are more capable of setting up conditions for their own learning than less mature students." In addition, Bigelow and Egbert6 reflected that successiul college students probably tend to be successful in both traditional and independent study. On the basis of comments cited above, it appears that there is reason to consider wider use of the independent study approach.
The independent study approach is vital in gerontological nursing education for several reasons. One of the major reasons is the great need for nurses prepared in the field. The independent study approach can be a means of introducing much needed content on gerontological nursing into the curriculum. While one of the reasons for teaching groups is economic, it should be realized that, initially, there may not be a large number of students interested in enrolling in gerontological nursing courses. Additional courses and use of the traditional approach can be added gradually, as faculty and student interest in the field increases. Although development of educational programs in gerontological nursing may be slow, societal need warrants attention to educational strategies that will prepare students to discharge their responsibility to the elderly as graduates. Thus, independent study is a viable option for individual students interested in the field of gerontological nursing and for developing a much needed resource of importance to the well-being of older persons.
While the question of cost-effectiveness of the independent study approach to gerontological nursing education is of concern, it should be studied from several angles. The price of inaction may be greater than the cost of action taken with respect to the societal need for care of the elderly. While the cost of educating students in independent study may be greater in some respects, the question is what would be the cost of a student lost to the program because of the lack of gerontological nursing in the curriculum? Independent study is usually carried out under the direction of a faculty member already on faculty. While it takes additional time and effort on the part of the faculty member, with careful planning the investment of time and energy may be minimized, especially for students at the masters level. The student taking an independent study in care of the elderly may, if satisfied with the experience, attract other students to the field of gerontological nursing that in turn, would affect cost factors. The other side of the cost-factor question is related to differences in the cost of supportive care and services that enable the older person to remain in his customary home versus the cost of institutional care. The gerontological nurse may contribute toward decreasing cost of care of the elderly through assisting the noninstitutional elderly. Thus, the independent study approach to nursing education in care of the elderly that, at first glance, seems cost-ineffective may, in fact, be cost-effective in the long run.
An example of an independent study project carried out by a student taking postmasters course work in gerontological nursing will be presented to illustrate use of the independent study approach. The student participating in the study was expected to meet academic standards just as students involved in the traditional group approach, eg, achieving course objectives, participating in clinical practice, and submitting evidence of work for grading and evaluative purposes.
The purpose of the independent study identified by the student was to identify and study, indepth, the supportive networks (formal and informal) of the elderly in a rural community. Because of interest in older persons, concern for the needs of elderly persons in rural areas and responsibility for teaching content in gerontological nursing, the student chose to conduct the study in her own community. The student had previously completed another course in gerontological nursing that enabled her to acquire knowledge of the support system of the elderly in a large metropolitan area. Therefore, she was also interested in making a comparison of the needs of the urban and rural elderly and of the supportive networks in each of the communities.
The four-credit project was completed during an eight-week summer session. The student-faculty advisor conference of three to four hours a week, plus the six to ten hours of clinical practicum per week, comprised the. formal time frame of the project. The student commuted (2H hours each way) once a week for the student-faculty conference and drove many additional miles to achieve her objectives for the clinical component of the project.
Methodology for the study related to aging and supportive networks involved extensive reading, including current research studies related to the subject under investigation. Four annotated bibliography cards were submitted per week and readings and other experiences were discussed in the weekly conference with the faculty advisor. Clinical practice consisted of visiting an older couple in a small town regularly throughout the semester, making health assessments on the couple and projecting a plan of nursing action. Additionally, the student visited selected community agencies,, interviewing staff members regarding the purpose of the agency and the objectives by which they planned to carry out the expressed purpose. As an outgrowth of the community experience, the student submitted a paper written on a problem of the elderly at the community level.
In the process of independent study, the student gained insight into the role and function of the gerontological nurse; the strength of an elderly couple motivated by a desire to maintain their independence, in spite of adversity related to health and financial problems; the reaction of persons from various agencies, when they learned of the student's involvement with the older couple and the attitudes and behaviors of those who were a part of the informal network system.
A major outcome of the independent study for the student was her realization that, in spite of the many problems of the elderly couple and the fact that the decisions they made were not always the same as those she would have made, they had a right to and were capable of making their own decisions. Ability to analyze the experience and to project ways of using the knowledge gained not only for working with elderly individuals, but for promoting the well-being of the elderly at the community level, further indicated the student's development.
This presentation is an example of how the independent study strategy may be used to meet the needs of individual students interested in gerontological nursing. It also shows how the non traditional approach can be used to incorporate content on care of the elderly into the curriculum. While the complexity of decision making regarding inclusion of gerontological nursing in the curriculum may be great, there are alternatives for handling the situation. One alternative is the independent study approach.
- 1. Roberts I: Should geriatric nursing be a specialty? Nurs Times 73(10):I566-1568, 1977.
- 2. Gilstrap RL, Martin WR: Current Strategies for Teachers. A Resource for Personalizing Instruction. California, Goodyear, 1975, pp 33-40.
- 3. Tough A: The Adult's Learning Projects. Ontario, Ontario Institute for Studies in Education, 1971, p 1.
- 4. Jourard SM: Fascination: A Phenomenological Perspective on Independent Learning. The Theory and Nature of Independent Learning. Pennsylvania International Textbook, 1967, p 80.
- 5. Gagne RM, Briggs LJ: Principles of Instructional Design. New York, Holt, Rinehart & Winston, Ine, 1974, p 188.
- 6. Bigelow GS. Egbert RL: Personality factors and independent study. J Educ Res 62(1):37-39, 1968.