Capturing learning from practice in practice

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Capturing learning from practice in practice

• Alison C Clark (lecturer), Pamela Winn (mentor)
• Natasha Williams, Delicia McKenzie, Felicity
  Callon (students)

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The practice setting is a learning environment
that may never achieve its full potential unless
ways are found to manage education alongside
other competing demandsPrice 2000
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The needs

• Mentors
• Specialist area determining level of practice
  expected level of competence a second year
  student could achieve, within a given time
  period, at a given point in the programme, and
• identification of learning opportunities
• interpretation of the NMC competencies /
  proficiencies difficult
• how to help students
• a) create and collate appropriate evidence of
  their learning to prove competence.
• b) manage their assignments workload

• Students
• 1. this is not nursing
•  
• 2. off you go .. very lucky if you see anybody
  felt very isolated some placements . more
  difficult to fill in competencies
• 3. really struggle with cant do the
  competencies in that book . ..cant do that
  here
• 4. portfolios how much evidence type of
  evidence linking it to the proficiencies

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Learning Sets small peer learning groups of
five to seven members who have an underpinning
desire to share learning Nottingham University
2005 p1
a way manage education in practice
The aim of the shared learning was to enable
the students and mentors to identify key learning
that was occurring, but often being missed in the
context of the everyday business of doing care
activities.
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Three learning sets

• Alcohol set for students working with people
  with problems related to drug or alcohol abuse
  and/or homelessness
• Elderly Set for students working with nursing
  teams assessing the elderlys long term care
  needs, and a
• Health Maintenance Set for students working in
  occupational health, a maxillo-facial outpatient
  department and a cardiac rehabilitation service

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Action Learning (Revans 1998)

• Action learning
• learning cannot be solely the acquisition of
  new
• programmed knowledge ..(p3) but is about
  searching
• the unfamiliar, of learning to pose useful and
  discriminating
• questions in conditions of ignorance, risk and
  confusion
• is about setting the students to tackle real
  problems that
• have so far defied solution (p4)
• learning equals programmed knowledge
  questioning insight.
• Provides
• opportunities for increasing student involvement
  and autonomy in the
• learning process(p64) Robinson 2001(religious

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Capturing learning from practice in practice
mentor and students perceptions of shared learning

• The intention was to capture the lived
  experience of student nurses, their mentors and
  a lecturer learning together, through reflective
  discussion /focused conversations on practice in
  practice.

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Method

• mentors and students learning logs their
  perception of their learning experience
• Focused discussion groups at end of placement
• Lecturer reflective diary of the process of
  supporting the students and mentors
• Independent diary analysis by educational
  consultant themes

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My learning experience Your log book please
write about your experience of learning within
the shared learning sets

• First session only
• Learning in groups was/was not a new experience
  for me?
• Learning in groups whilst on practice was/ was
  not a new experience for me?
• I like/do not like learning in this way
  because..?
• All sessions1. Awareness of learning.
• How did the session help you learn? What grabbed
  your attention? Did anything surprise you?
• Were you able to share your own views and
  experiences? What contribution did you make to
  the learning? Were you able to help anyone else
  in the group learn? Did anyone else help you
  learn, and if so how?
• Were you made aware of different points of view?
  How did this feel? Did the discussion challenge
  you in any way? Did you feel out of your depth
  at any time, and how did you deal with this?
• What factors helped or hindered your learning
  today? (The setting? The way the session was
  conducted? Who was present? The time and timing?
• What was your overall impression of the shared
  learning event(s)?
• 2. Transfer of learning
• Were you able to make links to previous learning
  in class or on placement? If so what and how?
• 3. Continuity of Learning
• How motivated do you feel to learn more? How do
  you intend go about managing your learning in the
  future?
• Would you share your learning with others in the
  future, and if so how?

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Themes identified from the literature

• Theory learnt can apply in workplace
• Trust own intuition
• Developed as social work manager
• Clearer goals
• Develop new ways of seeing
• More positive about my job
• More proactive /less dependant
• Gained from listening to others
• unstuck
• My thinking and or approach to has changed
• Clear now about my role as a student nurse, and
  my responsibility to learn
• Improved negotiation skills
• Improved communication skills
• Realise now need to think through things rather
  than just react to
• Benefited as a person
• Off loaded by distancing from issue

Reflectivity becoming reflective
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Themes confirmed the diaries

• Theory learnt can apply in workplace
• Trust own intuition
• Developed as student
• Clearer goals
• Develop new ways of seeing
• More positive about my job
• More proactive /less dependant
• Gained from listening to others
• unstuck
• My thinking and or approach to has changed
• Clear now about my role as a student nurse, and
  my responsibility to learn
• Improved negotiation skills
• Improved communication skills
• Realise now need to think through things rather
  than just react to
• Benefited as a person
• Off loaded by distancing from issue

Transfer of learning
Motivation to learn enhanced
Seeing progress Progress affirmation
Reflectivity becoming reflective Recognising
reflective process
Presence of mentors Added value
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students comments

• Refreshing (first meeting) because I have the
  support from mentors and the lecturer ..
  reassuring to have help at hand .. relaxing ..
  learning in this group is nice as everybody has a
  chance to talk and share ideas/thoughts /
  concerns and worries. This offers a sense of
  unity amongst the students .. my anxieties about
  how to fulfil the proficiencies have lessened
  (second meeting)
• I liked the opportunity to listen to other
  students experiences but when in a group I dont
  always feel comfortable talking about my own I
  liked it as we all have similar experiences and
  could relate to each others problems and offer
  solutions..
• I feel very motivated in learning more to manage
  my learning I intend to ask more questions of my
  mentor during my placement to clarify and verify
  my understanding this is to reinforce what I
  have learnt.. I will continue writing a diary
  about daily events .. to understand what I have
  done and what I need to look at again and
  understand better .. I will continue to write
  reflectively
• Useful getting the perspective of the mentors as
  well as the students ..(helped) .. me to gain a
  better understanding of what I have learnt on
  placement ..
• enjoy this way of learning as it allows the
  sharing of best practice , facilitates discussion
  about areas of practice that is going well/not
  well so that we are able to support one another
• A good opportunity to compare our experiences and
  link them back to things we had been taught
  earlier in the course , for example the BOE model
  of communication Doesn't
• .. its all a process of learning .. a new way of
  learning .. This way or work will be all relevant
  when I qualify ! lifelong learning

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A mentors comment

• Initially my thoughts were great well have fun
  .. A little apprehensive .. Found the whole
  experience quite good. Did however find having to
  justify my questions and reasoning a little
  nerve wracking. It made me more aware of what I
  am teaching
• I learnt how different areas in com (?community)
  are and how my approach to problems differ

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Perceptions of the learning experience

• Interpersonal element key
• Process become comfortable with the strategy
  
• share
• personal and professional development

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Perceptions of the learning experience

• Interpersonal element key
• Process uncomfortable
• comparison with others and low self esteem
  
• Becoming Confused
• knock pre set learning pattern

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Value of shared learning experience

• Becoming a professional
• Work based learning
• Professionalism
• Working with others
• Intradisciplinary learning
• Interdisciplinary learning
• Interprofessional learning
• Interagency learning

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Students conclusions - Value of shared learning
experience

• Gave me time and thinking space to assess my own
  personal and professional
• development
• I have learnt to take a step back
• Made me look at may work in a systematic way
  appreciate constructive
• criticism
• A package lectures theory.. Assignments
  portfolio practice
• Builds therapeutic relationship with mentor in a
  safe/unbiased setting
• Gave me a better idea on why we need to achieve
  these outcomes over the
• course of my training
• Gave me more of a chance to discuss with my
  mentor my opportunities during
• placement and gave me a chance to feel as part of
  the team
• Helped me to gain confidence

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Conclusion

• Potential framework for and strategy for
  lecturers
• to provide educational support in the
  workplace/
• practice setting (Meets NMC 20 of teaching hours
  requirements for practice support)
• Addresses mentor and students needs
• a learning placement rather than a
• work placement within real world of
• clinical practice

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Some key references

• Bourner T and Frost P 1996 Experiencing Action
  Learning Employee Counselling Today The Journal
  of Workplace Learning 8(6) 11-18.
• Burgess, R C 1999 Reflective practice action
  learning sets for managers in social work Social
  Work Education 18 (3) Sep 1999, p.257-70
• Dilworth RJ 1996 Action learning bridging
  academic and workplace domains Employee
  counselling today. Journal of Workplace Learning
  8(6) 45-53
• Douglas S, Machin T. 2004 A model for setting up
  interdisciplinary collaborative working in
  groups lessons from an experience of action
  learning.J Psychiatr Ment Health Nurs.
  Apr11(2)189-93
• Johnson C 1998 The essential principles of action
  learning. Journal of Workplace Learning 10 (6/7)
  296-300
• Laurillard D 2002 Rethinking University Teaching
  a Framework for Effective Use of Educational
  Technology. 2nd Ed. Routledge Farmer.
• Lave J and Wenger E 1991 Situated learning
  Legitimate peripheral participation Cambridge.
  Cambridge University Press.
• Mumford, A. 2006 Action learning nothing so
  practical as a good theory action learning 3
  (1) 69-76
• Mumford A 1996 Effective learners in action
  learning sets Employee Counselling Today. The
  Journal of Workplace Learning 8 (6) 3-10
• Nursing and Midwifery Council 2008 Standards to
  support learning and assessment in practice
  London NMC
• Pask G 1961 An Approach to Cybernetics Hutchinson
  and Co. London
• Plumb, K 2006 Learning lessons from health
  visiting modernisation in Bromley Community
  Practitioner, vol. 79, no. 12, pp. 400-405, Dec
  2006
• Revans RW 1998 The ABC of Action Learning
  Chartwell-Bratt. Bromley
• Schon D A 1983 The reflective practitioner how
  practitioners think in action London Jossey Bass
• Stark, S 2006 Using Action Learning for
  Professional Development
• Educational Action Research, vol. 14, no. 1, pp.
  23-43, Mar 2006
• Stroobants H Chambers P Clark B (Eds) 2007
  Reflective Journeys a fieldbook for facilitating
  life long learning in Vocational Education and
  Training
• Taylor C 2007 A collaborative approach to
  developing learning synergy in primary health
  care