Nursing Education and Learning Activities, Clinical Practice Courses & Immersion Experiences
Learning Activities for Interactive Classroom Teaching In Nursing Education
When students and faculty engage, four cultural encounters are involved: being a student, being a faculty member, learning in the academic institution or clinical practice setting, and being in a given country or region. If alliances are formed in a mutually respectful way, learning takes place in a bidirectional manner.
Systems then can be developed to ensure that students have opportunities to engage in learning activities with peers from different racial and ethnic groups, peers with age variations, and peers who are both male and female. In addition to student interaction, a diverse mix of experts from the community can be used for classroom activities as appropriate.
These individuals, experts in their own right, are often willing to be involved in the education of students. Faculty should take advantage of the willingness of these individuals and use them to enhance inclusivity. In the classroom, learning activities should be planned to facilitate knowledge acquisition and interaction and collaboration of diverse groups of students.
Because all encounters are cultural encounters, each of these variations brings different experiences and perspectives. In other words, in the classroom faculty must move from lectures to activity and variety that promote an opportunity to interact with each other; seek understanding; and establish respect for diverse ways of learning, opinions, beliefs, and attitudes.
As cultural agents and role models, faculty can take actions that bridge gaps between students’ cultures of origin and the campus culture. Culture, like genetics, has a group definition but individual expression. The implication here is to provide a variety of learning activities that appeal to varying styles of learning, and for students to understand how their own learning style preferences affect their learning.
There is evidence that cognitive and psychological traits affect learning styles, academic performance, and the engagement of students. Using a variety of strategies and learning opportunities is particularly helpful to promote cultural understanding and competence. Faculty can assign students to write short papers describing themselves and then reflect on the descriptions.
Encouraging students to accept invitations from individuals from a different ethnic or cultural group to special events such as weddings, graduations, parties, and rite of passage ceremonies can broaden perspectives. Students and faculty should take advantage of programs both on campus and in the community.
When faculty accompany students, they can encourage a shared, common experience whereby faculty can talk individually with students and explain what the student is seeing, learning, and possibly experiencing. Faculty can make a list of cultural events and establishments such as ethnic restaurants and special museums to share with students.
Promoting reflection among students increases self-awareness. Faculty can engage students by designing written assignments, such as journaling logs or learning diaries.
Personal letters written by and for the student have a dual purpose of addressing personal fears, feelings, assumptions, and expectations about a planned experience or about different racial and ethnic or age groups, and later reflecting on the identified written content in preparation for writing a major paper.
The connecting link between the initial letter and the reflection could be a service-learning experience. Students can read the letters after the experience and reflect on the initial letter in terms of similarities to and differences from their previous thoughts, feelings, and assumptions, thus providing an avenue for deeper reflection, meanings, and considerable learning.
The letter strategy, used for 5 years in a course for beginning students,
resulted in noted improvement in the quality and specificity of papers and
enhanced learning as identified by students (Stokes, Linde, & Zimmerman,
2008).
Clinical Practice Courses for Attractive Learning In Nursing Education
Emphasis should be placed on inclusive teaching and learning not only in classroom settings but in clinical practice settings as well. As attention is given to making curricular and content changes, opportunities must also be provided for clinical practice so that knowledge is reinforced, skills are developed, and changes in attitudes occur.
The clinical setting is a place where cultures collide and research confirms that the experiences can be challenging. One study by Welch, Harvey, and Robinson (2010) identified that there is a mismatch of perceptions and expectation of knowledge, clinical skills, and level of performance between those of the majority, be they academia or stakeholders, and those of the minority.
Other studies concur that students participating in clinical experiences in a different cultural context required higher levels of support to enable them to perform at the expected levels (Boughton, Halliday, & Brown, 2010; Gerrish & Griffith, 2004; Jeong et al., 2010; Walker, 2009). Communication is an important skill in clinical practice.
To address the diversity of communication approaches, faculty can encourage students to actively observe different ways of communicating by summarizing news articles, watching television programs, and listening to the local news.
When doing so, faculty should direct students to observe eye contact and mention that faculty and students with a Eurocentric background prefer eye-to-eye contact and often view others who do not look them in the eye as dishonest.
Faculty can also use video clips, with examples of communication interactions between health care team members, and develop opportunities to practice different communications styles through the use of simulations and inter professional simulations with the health care team members.
Helping students develop culturally appropriate therapeutic communication skills is equally important. Harvey, Robinson, and Frohman (2013) emphasize the importance of communication skills and highlight that the development of conversational strategies and patterns can aid all students to perform at the expected level.
The authors note, however, that it can be difficult for students to change lifelong cultural ways of communication to meet the expectations of other cultures. When selecting clinical placement sites, faculty should plan to use both in-patient and community based facilities.
Faculty should make concerted efforts to ensure that one in every five patients selected for student clinical learning experiences is from a different cultural group. Checklists or databases can be established for students and faculty to monitor and track the gender, age, racial and ethnic makeup, and socioeconomic status of patients assigned for care.
When using these tracking systems, faculty should take the time to explain the systems being used and the rationale for their use with students. By visiting urban areas or specific cultural districts, faculty can provide opportunities for students to view areas of the community that are different from their own, and conduct an organizational climate audit as part of their assignment.
For example, grocery stores, storefronts, houses of worship, health clinics, and businesses could be among the destinations. Often manufacturing plants and waste sites may be close to housing communities of the underserved. Students can be directed to books, movies, and stage plays that depict an image of life as experienced by varied cultures.
To make these worthwhile experiences,
faculty can assist students in developing focus points that can direct their
observations, conversations, and discussions before and following the
experience.
Immersion Experiences Involvement In Nursing Education for Best Outcomes
Immersion experiences are another beneficial approach to integrate content, engage students, and afford opportunities for reflection and the development of cultural competence. Faculty can use immersion experiences in several ways. One experience can be service learning with agencies that serve culturally diverse patients or those that have a specific patient population.
The benefits of such experiences are multifaceted (Hunt, 2007). Caffrey, Neander, Markle, and Stewart (2005) conducted a study to evaluate the effect of integrating cultural content in an undergraduate curriculum on students’ self-perceived cultural competence and to determine whether a 5-week clinical immersion in international nursing had additional effects on students’ self perceived cultural competence.
The results of the study revealed a larger gain of self perceived cultural competence for students who engaged in the immersion experience. Another form of immersion is through the use of ethnographies. Ethnography refers to a written presentation of qualitative descriptions of human social information based on fieldwork. Brennan and Schulze (2004) engaged students in reading ethnographies.
The activity was followed by a written assignment of an analysis of the reading. Presentations and discussions of the analysis were made in groups. Results of the ethnographic analyses indicated that students were immersed in the culture.
Group discussion of the analyses was beneficial in providing a multicultural experience for all participants. Experiences can also occur through spending time and engaging with specific cultural groups within the United States (e.g., special populations) and abroad.
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