Traditional Forms of Learning Do

¶ … Traditional forms of learning do not take into account what learners learn and how they learn it (Peters, 2000). Constructivists, such as Peters look at learning as being built or constructed by individuals, in contrast to information that experts disseminate to passive learners. Constructivist learning provides skills that enhance understanding at the same time as learning. Peters noted that nurses educated with constructivism are more prepared to transition to practice settings.

Learning skills sharpened in the constructivist environment offer graduates with metacognitive ability, an essential aspect of active and self-directed learning that is so vital in nursing. According to Osterman (1998), who is known for her work with reflective learning, "Reflective practice is a professional development strategy with roots in the constructivist paradigm." Central to both constructivism and reflective practice is the belief that ideas and action are integral, interdependent, and essential aspects of the learning process.

Although reflection and reflective learning have become increasingly promoted in nursing education, and education in general, there is no overall agreement on term definitions. Boyd and Fales' (as cited in Thorpe, 2004) definition of reflection as "the process of internally examining and exploring an issue of concern, triggered by an experience, which creates and clarifies meaning in terms of self and which results in a changed conceptual perspective," is widely used. Reflective learning is recognized as a significant means for promoting active learning among nursing students.

Essentially, reflection offers nurse educators the ability to provide students with a means to think about past experiences, present situations, and expected outcomes of actions, so that they can explain what they are doing in the clinical setting and why. In this case, nurse educators are utilizing professional practice that is reflective rather than routine (Thorpe, 2004). According to Kember et al.

(as cited in Thorpe, 2004) "It is now widely accepted that successful professionals need to reflect upon their actions as most tasks they perform involve novel elements to which there are no defined solutions." Educators thus must prepare professionals for reflective practice and help nurses determine the extent to which learning actually occurs. However, whereas learning facilitation remains with the educator, the ultimate learning responsibility rests with the learner. Senge (as cited in Thorpe, 2004) notes: "Real learning gets to the heart of what it means to be human.

Through learning we become able to do something we never were able to do. Through learning we extend our capacity to create, to be part of the generative process of life." In nursing education, reflective practice supports nurses as they move from routine actions to more considered, cogitative actions. According to Vallance (2006), this transformation makes teachers "better," or at the very least aware of their pedagogical practice and beliefs. Teacher education programs worldwide therefore integrate reflective practice into the curriculum as a valuable and effective record of teaching practicum.

In order to provide a better idea on how reflective practice works in nurse learning and advancement, Teekman (2000) conducted a qualitative study with ten registered nurses. The goal was to study reflective thinking in actual nursing practice. The authors analyzed ten non-routine nursing situations for the presence of reflective thinking and a total of 59 "micro-moments" when thinking processes were used to make sense of a situation as well as focus the nurse's thought. Pre-perceptions acted as an important part of how the nurses perceived their situations.

Reflective thought was demonstrated particularly in times of doubt and confusion and included such cognitive activities as comparing and contrasting, pattern recognition, perception categorization and framing. In addition, self-questioning was an essential aspect of the reflective learning process.

It was found that nurses use three hierarchical levels of reflective thinking: most often, they engage in reflective thinking-for-action centers on the present in order to encourage action; reflection thinking-for-evaluation focuses on establishing wholeness and is added to the recognition of numerous perceptions and responses; and reflective thinking-for-critical-inquiry, the highest level, transcends from the actual experience to expose ideological and hegemonic conditions and challenge the status quo.

However, Teekman (2000) found that learning from experience does contribute to know how or practical knowledge, but trusting this know how requires a great deal of confidence by the learner, because of the transition from reliance on the abstract, to analytical rule-based thinking to clinical reasoning based on past experiences. This often takes an expert reflection practitioner, who is not just a nurse with a great deal of experience, but a practitioner who can move between the two forms of knowledge and select and transform knowledge that the situation demands.

As Schon (1987) noted, it is this ability to move from theory to practice that ultimately results in the practitioners' professional growth. It should not be assumed that improved skill in reflective thinking equals learning, which equals improved nursing practice. Reflective practice can reinforce rather than eliminate inappropriate action tendencies. Schon was concerned with this possibility and recommended role models working side by side with students. It is necessary to remember that reflective thinking is not something that happens automatically.

It requires active involvement and a clinical environment supportive to the learners' needs. Fink (2003) recognized the importance of learning-centered as opposed to content-centered courses. He proposed that learning encourages change, and lasting learning. Fink urged teachers to clearly impart important knowledge and strive for students' conceptual understanding of that knowledge. For truly significant understanding and remembrance, there must be full recollection even a year after the course is over. The value of striving for application in a course, beyond the expected cementing of knowledge, is that it allows useful learning.

For a course to be successful, the participants must care about it and the subject matter. Fink stressed that this caring provides the momentum or energy required for gaining knowledge. When students lack the energy for learning (caring) there is no significant outcome. The question presented here is whether or not reflective learning is a practical means for providing nursing students education for the long-term.

As noted above, reflective learning is becoming the standard for instruction and an essential way for breaking away from traditional learning that is teacher-centered and student passive. Reflective learning has a number of benefits. Loughran (2002) provides several reasons why the reflective process is so critical to educational continuous improvement. 1) Problem Solving. Through analysis, the ways of and reasons for acting in a specific way are made explicit, including recognizing areas that may be problematic. 2) Viewing Problems. It is necessary in a practice setting to see a problem in different ways.

If a nurse only sees one ramification of the problem it will influence subsequent actions. 3) Rationalization and Justification. There is a difference between justification and rationalization. Justifying a practice means that a process is being used because of a specific knowledge or thought in that situation. Rationalization is continuing to adhere to an approach despite the situation, because alternative ways of seeing are not possible. 4) Experience and Reflection. Experience is always helpful, but sometimes it can lead to take-it-for-granted conclusions.

Thus, through reflection on one's actions, it is possible to look at different perspectives and realize that in certain cases experience is influencing decisions in a wrong direction. 5) Using Anecdotes. Constructing a personal account of a situation from different perspectives helps to reshape the nurses' views about their medical approach. 6) Experiential Learning. Effective reflective practice consists of watchful deliberation of both seeing.