Journal of Nursing Education

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dialogue as a method of teaching

Helen G Wolford

Abstract

Dialogue: A conversation or reasoning by two or more persons on some topic or circumstance, as in the dialogues of Plato.

It is being said, and demonstrated as well, that the student-teacher relationship is not all that it could be. Long ago certain methods of reaching students were instituted, many of which are as effective now as they were centuries ago. Of them all, the tutorial method probably is the most preferred as a means of interchange between the teacher and student. In the tutorial method ideas and concepts may be developed and brought to fruition, and it also provides opportunities for drawing students out, which is a vital factor in enabling some of them to attain their best in achievement.

The art of exploratory interchange, which is the essence of dialogue, is a creative endeavor in which any teacher may become adept. The individual attention afforded the student in this relationship seems to have an almost magical effect as, often, a student who is a quiet, uncommunicative student in a group will suddenly unfold and speak out in the privacy of a personalized conference.

How well does a teacher need to know a student? Just as the nurse seldom knows her patients well enough for her to mean all she could to them, it is the same with the teacher and student. The depth and quality of some relationships, depending upon the purpose to be served, can mean the difference between success and failure in accomplishing that purpose. Since part of the process of nursing lies in putting theory into practice, that is, freshly gained knowledge is quickly transmitted into active nursing functions, the conditions maintained must be such that dialogue flows freely between the teacher and any one of her students. The perceptive teacher attempts to establish rapport with her students, just as she encourages her students to establish rapport with their patients. In contrast to other methods of reaching students, much of this rapport can be accomplished in a private discussion between the student and the teacher, and in this encounter, each participant becomes a person. In such a relationship, a finer, deeper meaning than "individualization" is sought.

Martin Buber made an important distinction in this regard in his book entitled/and Thou, as paraphrased by Paul Tournier.1

The whole difference between an individual and a person is that the individual associates, whereas the person communicates. There is the same difference between the personage and the person; the personage is an external appearance which touches the personage of others from outside, the person communicates inwardly with the second person, the 'thou.'

Adroitly contrived, the one-to-one interaction between teacher and student far surpasses the multiplicity of the collective classroom mind, as in private, distractions, passivity, and other impediments to intellectual germination can be minimized. Unconcern, withdrawal, feelings of inferiority, fear competition, and personality conflicts often devitalize group situations. Despite the emphasis which is put upon group dynamics, and despite the skill displayed by a seasoned leader who may know how to elicit the best from every member, it is still not an ideal learning situation. Certain individuals invariably seize control, and, under a so-called "permissive" leader or teacher, may dominate the rest of the group. As a result the atmosphere makes the timid even more timid

Lecturing a large class rarely gives the teacher a chance to know his students by face and name, much less as separate persons. Of the total class, one or two students may stand out for him uniquely, but this frequently occurs out of happenstance more than plan, and may become a fortunate circumstance…

Dialogue: A conversation or reasoning by two or more persons on some topic or circumstance, as in the dialogues of Plato.

It is being said, and demonstrated as well, that the student-teacher relationship is not all that it could be. Long ago certain methods of reaching students were instituted, many of which are as effective now as they were centuries ago. Of them all, the tutorial method probably is the most preferred as a means of interchange between the teacher and student. In the tutorial method ideas and concepts may be developed and brought to fruition, and it also provides opportunities for drawing students out, which is a vital factor in enabling some of them to attain their best in achievement.

The art of exploratory interchange, which is the essence of dialogue, is a creative endeavor in which any teacher may become adept. The individual attention afforded the student in this relationship seems to have an almost magical effect as, often, a student who is a quiet, uncommunicative student in a group will suddenly unfold and speak out in the privacy of a personalized conference.

How well does a teacher need to know a student? Just as the nurse seldom knows her patients well enough for her to mean all she could to them, it is the same with the teacher and student. The depth and quality of some relationships, depending upon the purpose to be served, can mean the difference between success and failure in accomplishing that purpose. Since part of the process of nursing lies in putting theory into practice, that is, freshly gained knowledge is quickly transmitted into active nursing functions, the conditions maintained must be such that dialogue flows freely between the teacher and any one of her students. The perceptive teacher attempts to establish rapport with her students, just as she encourages her students to establish rapport with their patients. In contrast to other methods of reaching students, much of this rapport can be accomplished in a private discussion between the student and the teacher, and in this encounter, each participant becomes a person. In such a relationship, a finer, deeper meaning than "individualization" is sought.

Martin Buber made an important distinction in this regard in his book entitled/and Thou, as paraphrased by Paul Tournier.1

The whole difference between an individual and a person is that the individual associates, whereas the person communicates. There is the same difference between the personage and the person; the personage is an external appearance which touches the personage of others from outside, the person communicates inwardly with the second person, the 'thou.'

Adroitly contrived, the one-to-one interaction between teacher and student far surpasses the multiplicity of the collective classroom mind, as in private, distractions, passivity, and other impediments to intellectual germination can be minimized. Unconcern, withdrawal, feelings of inferiority, fear competition, and personality conflicts often devitalize group situations. Despite the emphasis which is put upon group dynamics, and despite the skill displayed by a seasoned leader who may know how to elicit the best from every member, it is still not an ideal learning situation. Certain individuals invariably seize control, and, under a so-called "permissive" leader or teacher, may dominate the rest of the group. As a result the atmosphere makes the timid even more timid

Lecturing a large class rarely gives the teacher a chance to know his students by face and name, much less as separate persons. Of the total class, one or two students may stand out for him uniquely, but this frequently occurs out of happenstance more than plan, and may become a fortunate circumstance for only a few. Although many teachers kindly and sincerely offer after-class help to students, the students who are in the greatest need often are simply unable to muster the courage it takes to ask to speak privately with the teacher in the first place. When the teacher takes the initiative and sets an appointment with the student it may be quite a different matter. But then, of course, what takes place during the appointment could be a critical factor. If the tone of the dialogue set by the teacher is hurried, formal, autocratic, and punishing he has wasted his time and he may have contributed to the student's regression as well. His door may have swung shut for future encounters. In nursing, for instance, this type of dealing with students, diffident ones especially, has wrought formidable repercussions as many students bear scars from the episode, and the resulting underlying resentment is unconsciously reflected in a turning upon others in "getting even" behavior. It is self- perpetuating, just as its antithesis is.

Although the greatest gains from dialogue may be reached in the one-to-one relationship, it can also be utilized to advantage in the large lecture or seminar group situation if the teacher wishes to make use of it. He may, when exploring a certain question, find within the class a student with whom he relates well and engage him in a discourse - not an interrogation - which will lead the student into a discussion which is so involved and so interesting that the element of self-consciousness leaves the student and enables him to be at this best for a few shining moments. Other students may become inspired as they witness the interchange of ideas. In seminars a similar effect may be achieved if the teacher, instead of simply commenting when a student has begun to speak upon a certain topic or issue, engages him in dialogue around it. This technique seems to fascinate the other students in the group; it encourages developmental thinking as they listen, and stimulates new formulations which may not have occurred otherwise. A paper on Freud recently given in a senior seminar on personality development served as a vehicle for opening entirely different insights into Freud as a person than had been derived from previous lectures and readings about the famous psychoanalyst. "I see him in a different light than I had imagined him to be - this is much more interesting. I think I will be able to understand what he tried to do much better now," a student explained. The reasoning-together, exploratory method abstracts from students numerous possibilities to questions that have no exact answer. It opens much wider latitudes to them when Üiey are confronted with future experiences in which a variety of tactics and solutions may be employed.

Where dialogue seems to serve best, however, is in the private, personal conference the teacher holds regularly with the student. Depending upon the teacher's total schedule, a certain amount of time may be allotted to each student per week. The "psychiatric" fifty-minute hour is preferred by many who teach psychiatric nursing in supervisory conferences. These sessions deal primarily around nurse-patient relationships. Within this framework some teachers tutor, counsel, role play, and truly tailorize the session. It is not an evaluation conference in which the teacher tells the student how she is progressing, if indeed the teacher thinks she is. Nor is it a time to "psych-out" the student or become inquisitive about her private life and habits. It is the student's special time and chance, rather, when she may describe pertinent activities relating to her nursing, and in response, the teacher may sit quietly and listen, offering an oral punctuation, reflection, or suggestion now and then. These sittings can be acutely uncomfortable at times. A real interchange may not take place, and the spontaneity of sudden discovery may be sacrificed in an aura of formality. If the teacher feels secure and her ego defenses can be put aside at the possible expense of appearing ridiculous or admit she does not know all she would like to know, a more profitable time may be spent Tournier speaks of this in his book, T7ie Meaning of Persons. 2

And I begin to tell him of my own experiences. I try to be as honest with that man as he is with me. The result is that the picture he had of me, as a personage wearing a halo of science, of faith, and of moral perfection -a role which, in spite of all my concern for honesty, I was not entirely innocent of playing in front of him -vanishes, allowing him a glimpse of my true person. We have both of us left convention behind, we are really encountering each other. This was what Dr. Dubois of Berne, one of the pioneers of modern psychotherapy, meant when he said as far back as 1905: "Hold out your hand then to that poor sick man. Do not be afraid of frankly admitting to him your weaknesses, your inborn shortcomings. Bring yourself close to him."

This change of tone marks the beginning of a true dialogue, for then the personage effaces itself, and allows the person to appear. Tt depends sometimes on the briefest word, provided it be really personal, or even on quite intangible factors.

The give and take and spontaniety in dialogue pretend less than structured conferences do and provide for a wide range of teacher-student activities during the hour. The freedom of it leaves little room for agendas or stultifying sessions where the teacher or the student assumes the role of "teller." With every student the tone and activity differ, and the place and time the conversations occur depend upon the reasons she and the teacher come together. Often the mood of the student is carefully considered as a clue and a point of reference, although no allusion may be made to it. Sometimes, in getting acquainted, as when strangers do, usually there is anxiety, but once this stage is over the sessions go quite smoothly. One active senior who came for the first time and sat opposite me wriggled about for a few moments and finally appealed to me in desperation, "Mrs. Wolford, I just can't sit still and not do anything with my hands." She told me that surgical nursing was her favorite, primarily because she could channel her energy into something "useful." To relieve her discomfort I put out a box of colors and gave her some mimeographed scenes to work on, which seemed to thoroughly delight her. I remembered, then, her rapid accomplishments on a colorful afghan she had been making in one of my seminars. After she became engrossed in thoughts about her patients, and we gradually came to know one another better, the energy outflow she characteristically bore was taken up in the enthusiasm engendered by an animated conversation. Psychological props serve well toward overcoming the awkwardness of unf amili arity and alleviates the discomfort of strangeness, whether the encounter is between a student and the teacher or a student and a patient. Process recordings, nursepatient data, or other similar material can be used as a means of getting started and can be discarded later when their purpose has been outlived. By then the student is initiated well enough to the conference idea, with its values and enjoyment for her, and she looks at the teacher more and more as an interested, able discussant with whom she may relate in a free and unguarded manner. It was summed up this way by a participant teacher:

From the animated expression on students' faces who sit across the desk from me, they can't be too tense or inhibited. They seem so thrilled and earnest and want to try so many things. Some actually seem to outreach themselves in experimenting with new ideas or ways unfamiliar to them. They have succeeded in opening new avenues for oncoming studente, are presenting a very favorable image to patients, and are making an important name for themselves with their colleagues. I sincerely feel that many of the ardent attempts made by these fledgling nurses will ultimately amount to lasting contributions to the nursing profession.

Interwoven with the glow of this happy comment is the fact that, at times, this same teacher sees that her students are depressed And she knows it is part of their practiced facade not to show it. As the students are encouraged to be as they feel, with a chance to ride the depression out rather than denying or concealing it, they move toward a better understanding of themselves and other people as they undergo this normal cyclic reaction in the matter of living.

Poise, grace, humor, and a penchant for analyaiing and selecting can be woven into the fabric of the student's being. Such attributes cannot naturally be activated from memory lists, automated, superfically projected, or taken on situationally as one's personne. The gradu ablese of assimilation and acculturation permits pauses and plateaus which let one consider things with a relative degree of leisure -opening wider ranges and vistas for thinking, integrating, and acting than does a conditioned response to an order. Somewhere in nursing the student needs to bring herself more closely to herself as a person, not a semblance of this caricature or a different personality wherever she imagines a stereotype might fit. Rather than becoming a stable, unique, balanced person in her constant casting about for the right occasion, she may have some difficulty in knowing exactly who she is.

As a member of a helping and healing profession an inner strength and resourcefulness enables the nurse to stand, to give, to care -to extend beyond the dimensions of the here and now- and to mean more to people than a functionary. Chaotic conditions, chronic personnel shortages, and an abundance of pathology, with its human sadness and affliction, demands qualities of strength in a nurse which are manifested in gentleness, personal concern, and a surety which lets her patients know and feel that they may count upon her to see them through the worst there is to come. Nurses who are able to be such persons have to be developed The young student must be guided, tended, and inspired toward this end, as the exigencies of the times do not warrant waiting until the wouldbe nurse arrives "naturally."

Further, she can learn to be, or come nearer her selfhood, as she engages in dialogue, in the I-Thou relationship with others in a mutuality of being. "Genuine dialogue," Buber contends:3

...can be either spoken or silent. Its essence lies in the fact that each of the participants really has in mind the other or others in their present and particular being and turns to them with the intention of establishing a living mutual relation between himself and them. The essential element of genuine dialogue, therefore, is "seeing the other" or "experiencing the other side. "

The attitude of "being with" can be effected between student and teacher in its finest sense without a word being spoken in reference to it. Both know they are together in something sound and meaningful, and from the experience, both can benefit in the care and purpose they subsequently bring to the endeavor to which they are committed.

References

  • 1. Tournier, Paul, The Meaning of Persons, Harper and Row, New York, N. Y. pp. 129
  • 2. Ibid, pp. 135
  • 3. Friedman, Maurice S., Martin Ruber, The Life of Dialogue. The University of Chicago Press, Chicago, IU., 1956 pp. 87

10.3928/0148-4834-19650801-07

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