Research paper on Teaching And Learning Principles & Practices
Learning continues in any age, learning is one of the main sources with the help of which improvements can be made by the individuals in their personalities. This paper will highlight reflective learning program in healthcare requiring certain outcomes based on specific objectives. One of the main aims of this paper is to educate the nurses the mode of treatment of anaphylaxis. The reflective learning will make sure that the nurses are aware of the way the patients of anaphylaxis are to be dealt with and how they are treated.
The learning activity that will be detailed out in this paper was for the purpose of learning in a group of nurses in a chosen hospital. The main activity based on which the educational activity for the nurses is chosen is the treatment of anaphylaxis. With the help of the chosen educational activity, the nurses would be informed and educated about the better and more improved techniques with the help of which anaphylaxis can be dealt with in the patients. One of the main facts that need to be mentioned here is that the role of nurses is much more important as compared to the roles that are played by the healthcare providers or the physicians (Clissett, Porock & Walker, 2013). This is because before getting in touch with the doctors or the healthcare professionals directly, the patients talk to the nurses. The impact of the services provided by the nurses is the decisive factor of the overall healthcare services provided by the healthcare providers. Anaphylaxis has been defined in many ways bit one of the main ways of defining and more understanding the condition is that it is an extreme form of allergic reaction which can prove to be fatal. Thereby it is important that the medical treatment is provided to the patient on an urgent basis. Based on the nature of the medical condition, there are chances that the patients are highly demanding and irritated (Husebø, Dieckmann, Rystedt, Søreide, & Friberg, 2013). Thereby other than just giving medical treatment to the patients, the nurses need to make sure that they deal with the incoming patients in the right manner. This will be achieved with the help of the educational activity. The additional knowledge that the nurses would gain would help the nurses in learning more about improving their overall performance and also in making more improvements in patient dealing. Thereby, one of the main outcome and result of the teaching program that was desired was to make sure that the nurses are more aware of anaphylaxis and the ways that can be used to treat it. Along with this the nurses will be given additional reflection on communicating in the best ways with the patients (Baldwin & Greenwood, 2008).
As mentioned in the previous section, the learners are the nurses who are responsible for looking after and managing the patients suffering from anaphylaxis. The basic learning based setting that will be used in this section is reflection. One of the main reasons based on which reflection has been chosen as one of the main learning based setting is that it can help in brining improvements on an individual learning thereby developing lifelong learning. The chosen nurses belong to high educational backgrounds. The nurses are aware of their duties and the changes that are required in their overall performance to make sure that better healthcare services can be provided to the anaphylaxis patients. It has been realized by the nurses that there is a need to make improvements as these improvements can result in the overall success of the organization. There are various techniques that are used for reflection based learning. One of the main models of reflection that will be used to educate and teach the nurses is the Gibbs Model of reflection. This model of reflection is one of the most well known models. It was presented in the year 1988 by Graham Gibbs. The model is used on structured debriefing in order to make sure that the reflection can be facilitated (Ritchie, 2012).
One of the main aims of the session is to make sure that the nurses become more aware of anaphylaxis and the treatments that can be given to the anaphylaxis patients to make sure that they become stable (Lillyman & Merrix, 2012). The learning objectives that are to be achieved in this session are;
- To make the nurses more aware of anaphylaxis;
- To make the nurses are aware of the treatment modes of anaphylaxis;
- And to make the nurses find ways to make more improvements in their patient dealing procedures and overall medical practice in order to make sure that they calm the patients.
Gibbs model of reflection will be used as one of the main reflective leaning strategies for this session. The duration of the session will be around 7 days. The main strategy that will be followed in this session is that the nurses would be gathered. To make sure that there is an increased learning, the method of structured debriefing has been proposed by Gibbs (Aronson, 2011). There are certain stages of structured debriefing as proposed by Gibbs. These include description, feeling, evaluation, analysis, conclusion which include both general and specific conclusions, and based on this learning, the personal action plans. The first step, the description will ask the nurses of an event in which they encountered an anaphylaxis patient. The second step is the feelings in which the nurses will give a description of the feelings that they has during the sudden event. Both these steps are purely descriptive and the nurses would be told of simply giving descriptions and not try to make any judgments or draw any conclusions. The third step is evaluation (Wald & Reis, 2010). This is the step in which the nurses will judge the experience and will evaluate their experience. It is important that the nurses make valuable judgments here. How bad or good the experience was and what was needed than. Analysis is the step in which the nurses will add in their own ideas about the experience. What could have helped to make the situation better, were the experiences of the other nurses similar or any different, and how can the nurses make sense of the situation (Zigmont, Kappus & Sudikoff, 2011).
Thinking and reflection have been compared by many philosophers. It has been argued that reflection helps in problem solving by making the person ponder over the problems and investigating the problem during the moment of thought (Arafeh, Hansen & Nichols, 2010). With the help of refection, an individual is made to think on the situations and conditions based on which the individual is working and the overall effects that can be seen by the individual afterwards. The philosophers have highlighted than the importance of reflection arises from the fact that it has the capability of reflecting the influences based on which there may be certain changes in the activities and performance of the individual (Bulman & Schutz, 2013). These are the influences which may be affecting the thinking behavior of the individual as well. When the psychological point of view is taken into account, it has been mentioned that reflecting can be considered as the main point of access to the main preconceptions. On the other hand, it has been mentioned that with the help of reflection, the person can analyze his own subjective thoughts. These subjective thoughts may be linked to the ideologies, beliefs and identities of the person (Powell, 1989).
When reflection is taken into account in regards to its importance in the healthcare, it can be added here that it is one of the main learning strategies with the help of which personal assessments can be carried out by the healthcare providers, nurses as well as the medical students (Frantz, 1999). The personal level of assessment may include the level of professional services that are being provided; the lags that they see in their performance and the possible improvement that they feel can be introduced to be better service provider (McGee, 2009). It has been mention that reflection is one of the main ways with the help of which individuals are encouraged to take a critical assessment of them in order to make sure that they can judge their own performance and work (Johns, 1995). In this way, the individuals can compare themselves and their performance with the ideas as well as the practices that they encounter daily. In most of the ways, the reflection can be defined as professional artistic in whom reflection can be used when the action has been performed s and during the action is being performed. Thereby from here it can be seen that refection can help support increased professional competency, as well as increased professional development (Kilgallon, 2012).
Based on these advantages, it has been seen that there has been an increase in the emphasis of usage of refection in healthcare learning processes. There are many approaches of learning through reflection. One of the main approaches includes experiential learning. In this case, the healthcare providers learn by reflecting on the recent experiences. But here it needs to be added that for additional and proper learning, experiences only are not enough (Jasper & Rosser, 2013). There is a need that the experiences are incorporated by the individuals in their existing knowledge (Rich & Parker, 1995). In this way, the knowledge becomes more expanded. There from here that for the crucial process of learning, reflection is important (Jasper, 2008). The second main form of reflective learning in the healthcare providers include learning based on therapeutical relationship between the healthcare providers and the patients. The experiences that have been gained in this can be effectively discussed with the peers and learning can be promoted. There is no doubt about the fact that these relationships are based on certain ideologies and beliefs and with the help of reflection, if needed, these can be challenged. The reflection has also been considered important for the development of better professional practice (Taylor, 2010). It has been mentioned that for the development of better professional expertise, one requires more than just higher education and skills. There is a need of experiences that have been incorporated into the existing knowledge. The situations that are faced by the healthcare providers are to be judged based on the information and knowledge sources that they have. Thereby with the help of reflection, a professional would have increased and repeated exposure to the come situations in the professional life which will help him in learning more and improving more. Thus reflection has been considered an important source of learning in healthcare. Personal analysis and assessments can help the professionals in learning (Holm & Stephenson, 1994).
One of the main models that have been chosen for the purpose of educating and learning in the nurses is the Gibbs model of reflection. The model is based on the method of structured debriefing. This means that there are six main steps in the reflective cycle and each step of the cycle is an explanation of the inner assessment carried out by the subject. This is the method that makes sure that there is more detailed refection based learning in the nurses. With the help of this model, the nurses will reflect on one of the experiences they have had with the anaphylaxis patients. As it has been mentioned that one of the main aims of the educational session is to make sure that the nurses are aware of anaphylaxis and the ways that can be used to treat the condition. The other main aim which will be achieved with the help of chosen reflective model is to make sure that the nurses are aware of the ways in which communication is to be carried out with the patients.
There are six main steps of Gibbs model of reflection. These six steps not only let the subjects remember and reflect towards the main experience and the event that took place but the model has certain steps with the help of which the subjects can analyze the experience (Fakude, 2003). What was the experience or the event, who were the main subjects of the event, what were the reactions to the event, and were the experiences of the other people similar to the reaction of the subjects. The section of analysis makes the subjects analyze the reactions that were given to the experience and the event and how the given reactions can be changed (Reid, 1993). This is the interpersonal reflection that will help the subjects in having a more critical view of the experiences on the event. Based on the analysis and the interpersonal reflection which is carried out by the subjects, the final step is the action plan. One of the main facts that need to be mentioned here is that based on the critical analysis carried out by the subjects, the action plan is defined and designed by the subjects themselves (Lillyman & Merrix, 2012). Thereby from here it can be seen that there are various advantages of the chosen method. The subjects will analyze and look into the event and experience in their own views and will analyze the response or reaction that was given at the event. When critical interpersonal reflection is carried out, the subjects will be more aware of the professional mistakes that they have made and how these professional level mistakes can be improved. Thereby with the help of action plan, the subjects would be able to define the new action or set of reactions that can be given at the event. Thereby, with the help of this session, the subjects would be able to have a critical view of themselves, in regards to the kind of response that was given at the mentioned event and how the response could have been different. With the help of this insight, the subjects would devise an action plan that they can use in the future if the same event is faced again (Ritchie, 2012).
The chosen educational activity is based on personal reflection. It has been argued that refection is one of the most well established concept for learning in the medical education and the professional development. the importance of reflective learning has been particularly appraised in the case of nursing as reflective learning has been known to underpin a more client based view as well as a more holistic approach. On the other hand, in these cases the assessments are more formative rather being of the summative nature. The main aims based on which the choice of educational activity was to make sure that there is an increase in the awareness and learning in the nurses in relation to the lags that they have in their professional activities. The nurses should be aware of the failures that are being seen by the patients as the nurses deal with the patients. There are various factors that need to be kept in mind as the nurses deal with the incoming patients. One of the main factors is the trust of the patients which develops based on the quality of dealing of the nurses. When the nurses communicate with the patients in a more positive and a welcoming and a hopeful manner, there is an increased positive perception in the patients about the higher level of communication based healthcare. Thereby there is a need that the nurses deal and communicate with the patients in a more positive and an optimistic manner.
One of the main facts that need to be mentioned here is that anaphylaxis is an extreme allergic shock. The shock can prove fatal until and unless proper and timely medical care and treatment is not delivered to the patient (Worth, Regent, Levy, Ledford, East & Sheikh, 2013). But in these cases, it is also important that the level of communication that has been adopted by the nurses is also positive. The patients in such emergency conditions need to be calmed down. Thereby the responsibilities of the nurses in these case are not only to provide proper and timely medical treatment to the patients but also to make sure that the patients are calmed down.
When the sessions were conducted, some of the main responses that were gathered from the nurses were recorded. There were a total of 20 nurses in the conducted session that had experienced or recently had dealt with an anaphylactic patient. In the first two steps which included description and feelings, most of the nurses mentioned that it was their second or third experience with an anaphylactic patient. They should have been aware of the way to deal with the situation, but still they panicked. One of the main reasons of the panic that was mentioned by the nurses was the extreme emergency situation of the patient and pressures that are exerted by the accompanying family members. Most of the nurses also mentioned that the proper, predefined and timely treatment was a well known procedure for anaphylactic patients. But this treatment was delayed based on panic and additional stress and pressures which are created by the family members of the patients.
In the case of the third and fourth step of Gibbs reflective cycle, which includes evaluation and analysis, critical self assessment was carried out by the nurses. The nurses afterwards mentioned that they are aware of the fact that the anaphylactic patient is already in a state of emergency and in a dire need of timely medication and treatment. This situation is already one of the main stress triggers for the nurses. The nurses mentioned that they are already under enough professional pressures of delivering high quality medical healthcare to the incoming patients. And the extra stress and pressure which is exerted by the family members of the patients creates obstacles and hazards in the timely delivery of high quality healthcare. One of the other main fact which was mentioned by the nurses was that being healthcare service providers, they should be able to handle extreme stressful medical emergency based situations. Additionally, it was highlighted by the nurses that they are aware of the fact that quality healthcare prison is defined by the delivery of high quality healthcare services in the situations of extreme emergencies. Thus it was mentioned by the nurses that they should have remained calm and in control even of additional panic was being created by the patient or the accompanying family members. The judgments that were given by the nurses included the fact that they are healthcare providers and they should have ensured the family members of healthy recovery of the patient in a timely manner. Because of panicking, the nurses mentioned, the timely treatment was delayed. In spite of the fact that the nurses were aware of the treatment, the physician on duty was consulted for the treatment which added into the delay in treatment.
The step in which the action plan was to be defined and decided by the nurses was interesting. In this case, the nurses came up to the white board and drew their action plans in the forms of flow charts. It was seen that most of the nurses wanted to be more independent in the decision making skills. They wanted to make decisions on third own when they faced an anaphylactic patient. This was based on the reason that they did not want any time to be wanted on asking around for the doctors for the treatments and medications of the medical condition which was already known. The nurses mentioned in detail that they have advanced and more up-to-date knowledge of anaphylaxis. The healthcare organization in which they worked believed in higher knowledge sharing. This was the knowledge sharing that made the nurses more learned about anaphylaxis and the kind of treatments that could be given to the patients. The nurses mentioned that some of the main databases from which they have learned more about allergies and anaphylaxis include American Academy of Allergy, Asthma, and Immunology (Cox, Lieberman, Wallace, Simons, Finegold, Platts-Mills & Schwartz, 2011). It was mentioned by the nurses that when they face a patient of anaphylaxis, they would make sure that the first step is to calm and sure the accompanying family members of the patient that the patient will be treated on time which will make sure that there is more timely recovery of the patient. Once this is done, the panic factor will be excluded and controlled by the nurses in an extremely effective manner. It was mentioned in the previous section that one of the main reasons of the failure of effective and timely healthcare delivery to the patient was the factor of stress and additional panic that was created by the family members of the patient. There is no doubt about the fact that it is the factor of stress the adds into failures (McDonnell, Pavy, Green & Platt, 2011). The next import step that was highlighted by the nurses in their action plan was to give quick and proper authorized treatment to the patient. In this case, the treatment would be authorized by the higher doctor on duty. Although the treatment has been decided and chosen by the nurses themselves, but they still mentioned that the authorization would be necessary. This was because if there are any changes needed in the treatment, it would be mentioned by the chosen authority. Additionally, the nurses mentioned that the kind of treatment or medication chosen by the nurses would be based on the situation and level of anaphylactic shock suffered by the patient. The nurses mentioned that maximum of 4 to 6 hours are required for the patent to recover from the condition and the patient is discharged afterwards (Simons, Ardusso, Bilò, El-Gamal, Ledford, Ring & Thong, 2011).