Journal of Nursing Education

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An Experiential Method for Teaching Research to Graduate Nursing Students

Patricia A Fazzone, DNSc, RN, CS

Abstract

ABSTRACT

This article provides a creative and interactive method for teaching a metaparadigm of inquiry that values and embraces both naturalistic and positivistic approaches to research. The author outlines an experiential method for teaching graduate level research that blends opportunities to meet the needs of students with either global or analytic information processing styles, as well as varying student learning styles. The method involves a semesterlong journey whereby students cognitively and viscerally begin to understand the interconnectedness of all research knowledge, and consists of five elements: 1) creating a nonthreatening environment; 2) using guided imagery; 3) teaching research along the "Continuum of Inquiry"; 4) take-home and midterm exams based on hypothetical clinical situations; and (5) developing a written research proposal.

Abstract

ABSTRACT

This article provides a creative and interactive method for teaching a metaparadigm of inquiry that values and embraces both naturalistic and positivistic approaches to research. The author outlines an experiential method for teaching graduate level research that blends opportunities to meet the needs of students with either global or analytic information processing styles, as well as varying student learning styles. The method involves a semesterlong journey whereby students cognitively and viscerally begin to understand the interconnectedness of all research knowledge, and consists of five elements: 1) creating a nonthreatening environment; 2) using guided imagery; 3) teaching research along the "Continuum of Inquiry"; 4) take-home and midterm exams based on hypothetical clinical situations; and (5) developing a written research proposal.

Understanding research is an ongoing struggle for many nurses and nursing students. Developing teaching strategies that enhance learning and comprehension of research has been an ongoing challenge for nursing faculty. Sequencing of courses in research methods and statistics, using national data sets for student learning, integrating research throughout the curriculum, providing a research practicum experience for students, and the use of group research project development and implementation, have added depth to the repertoire of teaching strategies (Ailinger, Howard, & Choi, 1997; Cole, 1995; Cuttini, 1994; Kee & Rice, 1995; Reed, 1995).

A new and exciting approach to teaching research is the use of creative, dynamic teaching strategies that engage students and offer opportunities for experiential learning. For example, role-play has been used as a means of putting psychological "research on trial1* to provide a creative, critical-thinking group learning experience where research issues can be debated (Britt, 1995). Britt sets the stage of a trial, with students playing roles of defense attorney and prosecuting attorney. Britt plays the judge. The students critique an article in great depth, the "defense attorney" defends the article, and the "prosecuting attorney" looks for weaknesses in the study (1995).

Another creative innovation for teaching research to nursing students, published by Sarosi and Taylor (1994), uses guided meditation and imagery to assist students in a personal journey of visualization to access meaningful research questions. Promoting tolerance for ambiguity and valuing creativity, Sarosi and Taylor offer a much needed strategy to assist students in their path toward critical inquiry. In addition, they challenge all of us to think of more creative and interactive ways to teach research and demonstrate the need for us to share our innovations.

In this article, the author describes a creative and interactive method for teaching a metaparadigm of inquiry that values and embraces both naturalistic and positivistic approaches to research. The author outlines an experiential method for teaching graduate level research that she developed in response to difficulties that graduate nursing students often had in conceptualizing, organizing, managing, and making sense out of research information. The method outlined in this article blends opportunities to meet the needs of students with either global or analytic information processing styles, as well as varying student learning styles (Van Wynen, 1997). The experiential method involves a semester-long journey whereby students cognitively and viscerally begin to understand the interconnectedness of all research knowledge. The method consists of five elements: 1) creating a nonthreatening environment; 2) using guided imagery; 3} teaching research along the "Continuum of Inquiry"; 4) take-home and midterm exams based on hypothetical clinical situations; and (5) developing a written research proposal.

THE METHOD

The 3-credit, 16-week graduate nursing research course, for which the method described below was developed, enrolled an average of 15-20 students. The graduate course was part of the first sequence of courses known as "core," and required as prerequisites that the student had successfully completed an undergraduate research course and an upper-division statistics course that included inferential statistics.

Creating a Nonthreatening Environment

The first element involves establishing a nonthreatening environment for group co-exploration of ideas and concerns. On the first day of class, students are given a large index card. On one side they write what they "think" about research and about taking this course. On the other side they write how they "feel" about research and about taking the course. An open discussion follows. It is very common for graduate students to think that the course will be "overwhelming" and that they will "fail" or "feel stupid" or "inadequate." These thoughts and feelings present a wonderful opportunity for faculty to help students put their fears and concerns in a more positive perspective. One might argue at this point that such concerns are natural and students need to "just get over it." The reality is, many don't and their fears, dislike, and distrust of the research process keep them from understanding and using research findings in their practice. Just as tragically, others, who have a burning desire to study something of great meaning to them, may never try. Therefore, creating a nonthreatening environment that deals directly and positively with student concerns is important to set the stage for more reflective and creative work.

Guided Imagery

The second element also takes place on the first day, and involves the use of guided imagery that focuses on accessing both the "critic" and the "adventurous explorer" internal parts of ourselves. An internal "part" or aspect of a person's personality influences the person's attitudes and actions. The critic is especially powerful when a person is dealing with fearful or unpleasant experiences. The adventurous explorer part helps unleash the daring and creative aspects of a person, and helps the person overcome the constraints set by the critic. The technique emerged from clinical psychological advances that explored the notion of a system of internal parts or aspects of a person that influence the person's thoughts, emotions, and behaviors (Gazzanga, 1985; Satir, 1978; Schwartz, 1995; Watkins & Watkins, 1986). A summary of the key elements of the guided imagery exercises for working with both critic and adventurous explorer are described below.

The imagery exercise with the "critic" accomplishes several things. First, students become very aware of how self-critical they are. The faculty asks the students to visualize and "become their internal critic." The students become aware of how it "feels" to be the critic and usually are amazed at how "old" and "rigid" they feel. They often dislike that aspect of themselves and see it as punitive. The faculty then explains that the role of the critic is a very protective one. Although seemingly very negative, the critic is a part of us that helps us connect and react to our fears and concerns. The critic within often "protects" us from the intensity of anticipated or actual failure and pain by shutting us down to negative or threatening external input. Unfortunately, this sometimes makes us critical of many aspects of a situation, other people, and ourselves.

After discussing the role of the critic, the faculty asks the students to have an "internal dialogue" with their critic and come to some agreement with it about allowing the student to learn, enjoy, and find meaning in research. When the critic agrees to allow more creative freedom without interference, the students usually know that something different has taken place. Some students audibly hear a part of themselves saying something internally such as, "Okay, G11 be quiet and listen," or they just feel a greater sense of freedom and relief. At this point, students usually feel more open to talking about their fears and concerns related to research. Dealing with student concerns is especially important early in the course when the students' fluency in the language of research is limited, thus limiting student comprehension and confidence. When the faculty can allay student anxiety and confusion early, it is easier for students to comprehend and meaningfully apply course content.

The guided imagery shifts from working with the critic to getting to know the adventurous explorer. Students now visualize the "explorer" part of them that loves adventure, feels passionate about things, and that loves to be free. While the critic remains silent, the student floats freely in the pleasurable image of being the explorer for a few minutes, experiencing a sense of pleasure and freedom they don't often feel in a classroom. Students begin to smile and laugh, and some begin to feel "pretty silly." When asked how old they feel, students often respond by saying they feel "little," between three and six years of age, or at an age when they felt most free in their lives. Only once in this author's experience did a student have difficulty "being free" in the classroom. The supportive comments from the other students about their own feelings helped the struggling student to relax enough to enjoy the experience; this in turn inspired her to try the technique again at home. The adventurous exercise frees students to think critically, creatively, and innovatively, without concerns about "feeling stupid."

Figure. The Continuum of Inquiry illustrates the relational nature of all research.

Figure. The Continuum of Inquiry illustrates the relational nature of all research.

The faculty person who uses this guided imagery technique should have some practice with this experiential method before using it with students. The faculty could practice it with other colleagues before including it in a professional repertoire of creative teaching strategies. It is essential that the faculty first create a safe, caring, and open environment for students; provide enough time to accomplish the exercises during one class session; and develop a personal comfort level with this style of teaching. The approach briefly described here is not a therapy session. Rather, it is an experiential method designed to enhance freedom of thinking, the co-creation of ideas, and the mastery of new insights. The author encourages faculty interested in the use of guided imagery to become familiar with some of the basic guidelines for use of guided imagery in the classroom setting, and to ponder the use of a variety of creative images to guide students into co-exploration of ideas and collaborative problem-solving (Tuyn 1994).

The Continuum of Inquiry

Element three involves the "framing" of the course. Framing takes place on the second day of class and involves the introduction of the Continuum of Inquiry (Figure). The continuum is a visual model of inquiry, and the experiential gestalt for the course. It provides a comprehensive view of research from the naturalistic inductive nature of qualitative research through the deductive reasoning of the positivist empiricist approach found in experimental designs. Although akin to, but not derived from the continuum of research designs related to causal relationships (Polit & Hungler (1991), the continuum of inquiry serves as a conceptual map from which the students navigate their way through their assigned readings, and through what they learn about in class. The approach grounds the student in the research process, and provides a comprehensive way for them to relate to, and understand the full spectrum of inquiry. The faculty teaches the continuum in several overlapping phases, and uses it throughout the course to teach both research content and process.

Phase One: Introduction of the Continuum

Phase I involves a visual walk-through of the continuum of inquiry and explores both inductive and deductive reasoning processes. Couched within this conceptual representation of the continuum are qualitative and quantitative approaches to research. The student's are introduced to the purposes, strengths, and weaknesses of each approach. The faculty discusses the relative nature of truth, and the importance of the inductive underpinnings of all research. The journey continues from inductive reasoning to the deductive phase of inquiry, highlighting the relationship between existing research data about a phenomenon and the type of research approach appropriate for further inquiry. The faculty uses the continuum as a road map toward greater understanding of the nature, specificity, and relational characteristics of a phenomenon under study. The Figure illustrates the relative positions along the continuum of ethnography, survey, and experimental designa.

It is here that the students see with greater clarity the differences between qualitative and quantitative approaches, the role and importance of each, and how they all fit together. The students are taught that the linear depiction of the continuum is not truly representative of the interconnectedness, multidirectionality, and fluidity of inquiry. The faculty reinforces that the continuum is meant only to serve as a gestalt: to promote a visual and visceral connection to the unified nature of all science.

Phase Two: Qualitative and Survey Designs and Methods

The second phase introduces research designs, and usually begins by the third week of class. The faculty draws the continuum model from phase I on the board, and reintroduces the continuum. The students discuss what they learned in the previous class. When the students achieve a basic level of comfort working with the model, the faculty introduces research designs. Starting at the qualitative research area depicted on the model (far left), the faculty begins to question students about what kinds of things they might do to get at information about a little understood or poorly researched phenomenon. Reflecting on their assigned readings on qualitative research, students offer suggestions, and an open discussion takes place. The facility member walks the students through the reasoning process facilitating students to consider whether the phenomenon should be considered on a personal or case-by-case basis, or whether it requires a social or cultural context of understanding. In addition, the students debate whether they need to look at just describing or denning the phenomenon, or if they need to explore relationships and associations between and among things related to the phenomenon. As the semester unfolds, the students continue to work from the continuum, begin to explore what kind of sample would be required for each type of design, and reason together about what type of data collection and analysis strategies fit each type of design. The discussions always emphasize the implication of each strategy, and the impact each decision has on reliability, validity, and generalizability of the data.

To facilitate integration and synthesis of the material, the faculty stands in front of the continuum depicted on the board, and physically moves along the model, directly referring to it as the students discuss different types of designs. Movement along the continuum model assists students in developing a greater understanding of, and relational reference to qualitative designs and survey. In response to faculty questions about designs and methods, the students engage in open discussion and then fill in the correct responses on their individual drawings of the continuum. For each type of research design students must decide on and provide a rationale for each of the following: 1) the purpose of the design (e.g., type of phenomenon under study and how much published research exists about the phenomenon); 2) the relative position of the design in relation to other kinds of designs along the Continuum of Inquiry; 3) examples of sample type, size, and generalizability; and 5) kinds of data collection and analysis strategies.

As a result of the co-creative thinking process and the grounding experience of placing their knowledge on a visual model, students cognitively and viscerally integrate the importance of the deep, thick descriptive data qualitative approaches yield, as well as the breadth and scope of information elicited through survey designs. In addition, students become more engaged in the reasoning process that determines selection of data collection, sampling, and analysis strategies. Students take home thenown evolving drawings of the continuum and are asked to review it and identify questions before the next class. Students also are required to submit written critiques: one on a published qualitative study and the other on a published survey research study. For each critique, students are expected to use the Continuum of Inquiry as a guide for their reviews.

At the beginning of each class, students again review all they have learned about the continuum and the research process to this point. In addition, the students openly discuss their critiques and the utility of the continuum. Strategies of reinforcement and open discussion provide an opportunity for students to collectively gain insight into the critique process. In addition, such strategies set the conceptual flow for the next set of designs and methods.

Once knowledge reinforcement and open discussion are accomplished, the faculty draws the evolving continuum on the board and physically moves along the model to dramatize the unfolding journey of inquiry. Students have explored designs that cover both depth and breadth of data, and are now ready to explore the role and importance of other pre-experimental, quasi-experimental, and experimental designs.

Phase Three: Quantitative Designs and Methods

Over the next series of sessions the students discuss how to explore relationships in environments that are not open to control, the nature of causal relationships, and the relative power of different designs to explain these relationships. Using the same teaching process, the faculty guides the journey along the path of deductive reasoning toward greater specificity and causality. The journey continues until the students reach the area of true experimental designs. At this juncture, the students engage in the decision-making process about when to use pre-experimental, quasi-experimental, or true experimental designs. Students are asked to submit a research critique on a published quasi-experimental or experimental study, and openly discuss their work and experiences with the continuum.

By now, students' have grasped the Continuum of Inquiry and understand the relational nature of various approaches to inquiry. It is relatively easy for them to refer to the model and consider the number of subjects, contexts, and conditions as they relate to each design along the continuum. Students move swiftly into making decisions about sampling and data collection methods for each design. The students consider the strengths, limitations, power, error, and implications for generalizability of each design. In addition, students consider sampling, data collection, and data analysis methods, and begin to posit the strategic benefits of triangulation. The students complete this phase by adding the quantitative designs to their corresponding "relative positions" on the continuum, thus completing the relative placements for both qualitative and quantitative designs.

Phase Four: Quizzes and Exams

Phase four occurs throughout the learning process. It involves a series of take-home quizzes that the faculty designs as tools for critical thinking and creative application of knowledge. They are context-based situations where inquiry is required to answer several important questions. Each quiz integrates contemporary clinical and professional role issues facing nursing today.

Students are asked to put themselves in the role of the researcher. Students read the description of the contextbased problem and develop a hypothetical research question based on the limited information provided in the situation. Students must identify where along the continuum the research question lies. In addition, students must discuss and provide a rationale for each of the following: 1) whether or not a qualitative or quantitative approach is indicated; 2) what design is appropriate; 3) what sampling and data collection methods are indicated; 4) what threats there are to reliability, and internal and external validity and how they will be managed; 5) how generalizable the findings are; and 6) what threats there are to the rights of human subjects and how they will be managed. Each quiz contains three or four different situations varying in complexity and difficulty. The situational information is limited intentionally. Students are encouraged to think creatively and critically as they consider applying their newly acquired knowledge in response to the situation. The students need to respond to two situations. Examples of such situations include:

1. A vice president for clinical services at the regional medical center has identified a problem with pain management in the neonatal ICU. She seeks consultation from you, the nurse scientist, to evaluate a new educational program for nurses about pain management. The project has not yet been implemented. They have been waiting for you to design and implement an evaluation of the effectiveness of the program.

2. A superintendent of a psychiatric hospital tells you, the nurse scientist, that staff on the child psychiatric unit are complaining that the children are very aggressive and unmanageable. She tells you "the unit has its own little culture and ways of doing things over there." She wants you to conduct a systematic study that will help her figure out what the issues and perceptions are, so that she can assist her staff and the children in a meaningful way.

Before the students leave class with the quiz, the faculty and students openly discuss similar context-based questions. In keeping with the nonthreatening environment approach, the faculty encourages students to consult their texts and classmates in completing the quiz, and to respond to the most difficult questions. The goal is to master the material, not fear it.

Students who have difficulty mastering knowledge application on the quiz are given two opportunities to improve both comprehension and application. First, discussion about the quiz occurs at the beginning of the next class. Students are free to discuss and advocate for their responses. This open discussion allows for clarification and articulation of the correct responses. In some cases, the faculty intentionally designs questions with more than one possible response. The group process and discussion that usually ensues is dynamic, creative, and bristling with curiosity and critical reasoning. Students rarely are bored. The faculty rarely is left unchallenged. Everyone has something to say; everyone has something to learn.

The second opportunity for students to improve involves a "second attempt" take-home quiz. Students need to review their texts and notes, reflect on the discussion about the previous exam on the same material, and apply that knowledge to the new context-based questions. The grade on the second attempt is final. All students have this opportunity to improve; almost all students seize it.

The midterm and final exams are modeled after the take-home quizzes, but cover much more material than any one quiz. These exams must be taken in class, they are open-book, and no consultation with classmates is permitted. The midterm exam usually consists of material inclusive of qualitative designs and methods. After the midterm exam the faculty can identify those students still struggling with core concepts, what concepts continue to be difficult for most students, and what information needs to be highlighted in open discussion. This must be accomplished before the journey through deductive reasoning begins.

Some critics of this approach may argue that allowing students to retake a quiz is labor intensive for the faculty. This may be so, and indeed may be prohibitive in very large classes. However, this author has found that the overall method provides enough opportunity for clarification, repetitive review of information, and extensive feedback on student application of knowledge. Based on the author's experience, few students ever needed to retake a quiz. Those students who did choose to retake a quiz were more confident, scored high on the second quiz, often chose the more difficult and complex questions, and were motivated and inspired to try harder. The author's experience suggests that when students are inspired to challenge themselves for personal improvement, they are more determined to master the subject matter, and experience substantial joy and satisfaction in their work.

Research Proposal

At the end of the semester students are required to submit a final draft of a research proposal based on an area of clinical interest. The proposals reflect the critical thinking and application of knowledge learned throughout the semester. Students submit parts of the proposal throughout the semester for review and comment by the faculty. In keeping with the open, creative approach to critical thinking in research, the faculty recommends that students read Writing Down the Bones (Goldberg, 1986), and Wild Mind (Goldberg, 1990), two wonderful books about freeing up the "writer" in all of us. Students revise their proposals on an ongoing basis until they believe their respective proposal reflects their best work. Students who use their own standards for excellence as a guide rarely accept less then their own best efforts. In fact, the author has seen students work harder and with more motivation when they are responsible for determining what personal excellence means.

FEEDBACK ABOUT THE METHOD

The author developed, and has used the teaching method presented here to teach graduate level research to nursing students. In addition, she presented this model in workshops to other students and colleagues from several universities. The responses have been overwhelmingly positive. Students in particular, enjoy learning through this method. It calms the students, grounds them, and focuses them, while allowing them to see research concepts within the big picture.

Graduate research students have commented openly about this experiential teaching method. Comments about the use of guided imagery include:

I am amazed at how getting to know the explorer in me made me feel so free and relaxed. . .1 plan on leaving the critic outside. . .As the critic, I saw an adult setting limits and restricting my efforts. . ,as the explorer within me I felt like a five-year-old child. . .1 felt pleasure in the freedom to reach out and learn and search without restrictions.

Student feedback about the Continuum of Inquiry includes the following comments.

It has simplified it to the point where I have achieved a concrete understanding of it. . .The continuum has served as a pattern or guideline for putting each new concept into perspective. . .It has been an invaluable tool. . .1 got so excited when the continuum was presented. . .1 could not believe that I had had a whole semester of research once before and I never understood it this way. . .it actually made me excited. . .This is a great tool for teaching undergraduate and graduate research. . .You should make a video of this so all students can learn this way.

Colleagues are surprised at the simplicity and utility of the Continuum of Inquiry, and see this approach as a model method for critical thinking and creative problem solving. Their comments speak loudly.

Wow, this is incredible. . .1 can't believe we dont teach research this way. . .This is fantastic, it makes so much sense.

CONCLUSIONS

The method of teaching presented in this article provides a multimodal, multidimensional, and action-oriented approach for teaching research. Although the method has not been compared and measured against other methods, student and colleague comments support the utility and effectiveness of the method. The experiential method for teaching research to graduate nursing students outlined in this article provides a nonthreatening climate of personal excellence and critical thinking. Strategies may be used individually or in concert as presented here as a method. In addition, the strategies including guided imagery are well suited for adaptation to creative and innovative web-based instruction. The author is currently designing web-based application of the experiential teaching method.

ACKNOWLEDGMENTS

The author wishes to thank the graduate nursing students, and Dr. JoAnn Gruca, at St. Xavier University, School of Nursing, Chicago, Illinois, for their enthusiastic support of faculty innovation and creativity. Dr. Fazzone was an assistant professor of nursing at St. Xavier University when she first developed the model, and at the time, Dr. Gruca was the assistant dean for the graduate nursing program.

REFERENCES

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10.3928/0148-4834-20010401-08

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