Preface Contents Acknowledgements About the authors List of acronyms Chapter a Chapter 2 Chapter 3 Chapter 4 Nursing, nursing science and nursing education Nursing Nursing science Education and training Nursing education The philosophy of nursing education References The history of nursing education: An outline Introduction Ahistorical overview of training before Florence Nightingale Florence Nightingale The development of nursing education in South Africa References Nursing theories and their impact on nursing education Introduction Philosophy, paradigm and worldview A philosophy of nursing The development of nursing theories Using a nursing theory and the nursing process Applying a nursing theory using the steps of the nursing process Nursing theory and nursing education References Global and local issues impacting on nursing education Introduction . Global impact on nursing education vii xi xiii 35Learming theories Behavioural lemming thor Socal teaming theory execs iceearng oe Aoccne treat Perspective Aestasoste earning teary Chapters The teaming environ ing environment The learning environment The nurse educator ‘The nursing student References Chepter7 Diversity issues in teaming larfication of terms ‘Approaches to learning Learning syles Intetectual development tevels Other diversity issues References Chapter 8 Thinking Thinking Functional thinking Critical thinking References Chapter9 Curriculum development Cursiculum, and related terms Education philosophy and the curiculum Curriculum models, xa ‘on leaning SEGSE £5588 seeeeey BEREE gg SSaR ‘Mscumectom demfopment process nner einige Totechng en teaning Toei Sedsin mins edation Teceiqes for integton coring Chapter Teaching and tearing sores ‘The calibers ‘orators one chalkboard The overhead projector Video and audio recordings Realobjecs ‘Stnalton techies nd resources Infomation technology leamingesourtes felerences ‘Chaper Cnia teaching and leaning neal teaching ond eat terms. ‘esponity for cna eaching Teaching or ini eompetence Cina teaching satetes nial ssesement References ‘Chapters3, Musing education detvery systems ‘Context ad challenges Comtact and tinted contac systems Distance education Issues of acess to education systems References Chapter 4 Assessment and evaluation of learning Cariicationofretated terms ‘Approaches to assessment Purposes of assessment and evaluation Principles of assessment ‘Assessment preparation 2e 2a, 305Wi "TEACHING AND LEARNING THE PRACTICE OF nUESiN@ Chapter is Chapter 6 Chapter a7 Index ‘Methods of assessment ‘Marking and grading assessments References Human resource and continuing professional development Definition of human resource development Framework for HRD in South Aftica The HRO Strategy for South Africa ‘The need for HRD in nursing The National Nursing Strategy Employer responsibilities in HRD The HRD process Definition of continuing professional development Nurse educator responsibilities in HRD and CPD References ‘Mentoring and coaching in nursing education Definition of mentoring ‘The mentoring cycle Definition of coaching Characteristics of coaching Types of coaching, The need for a coach ‘The principles of coaching ‘Acomparison between mentoring and coaching References Nursing scholarship Scholarship The nature of research ‘The steps in the research process The role of the nurse educator References Biz 323 327 Rp 330 332 334 337 339 341 3u2 342 346 348 351 352 356 360 360 362 364, 365 366 370 373 374 379 379 388 393 394 We hve writen Teaching and Learning the Practice of Nursing primarily for registered nurses who are nurse eduestors or who are studying toward Lvecoming murse educators, and for those who are directly involved in the teaching of nurses in clinical practic. The book rests on the assumption chat you its readers, are self-directed in the quest for knowlcdge and thatthe need {or information that isnot provided inthis text guides the route to your further learning. As such, we do not intend this to be a comprehensive text. We also assume that all professional education for nurses resides in higher education and thar it will besoin the future. Thus we use the term ‘student to designate give status toa nurse enrolled in an education programme. We use the term “Teames only to describe an individual (nurse) in the process of learning. Tn terms of style, we have written this book in such a way that it i as accessible as possible to you, the reader. Therefore, we use the term ‘we to zefer to ourselves as authors, in some cases to refer to nurses in general and in justa few cases to reer to people in general ~ the context ofthe sentence vill make the meaning clear in cach case. We always reer to yourselves as ‘you. Occasionally we may remind you of your position as nurse edueato, but mostly we address you directly. Furthermore, for ease of reading, inthis bbook we assume that the term ‘man encompasses all human hag tnd {emale respective of age; political, social and economic status; creed; culture and penal heath sa wile hehnti nclues + pts male aad female, ofall age groups, and ‘she7her’7hers includes a nurse educator and ruse practitioner, female and male . In writing this book we had two goals in mind: fst, to provide nursing education students and educators with information needed to understand the fundamentals of teaching and learning in order to fulfil their roles as learners and as facilitators of learning respectively. Second, co consistendy profile ‘nursing science and art that informs all reaching and all learning. In achieving these goals we decided on 17 chapters, carefully erafed 19 provide content on the pedagogy and processes of teaching and learning, the contents for teaching and learning, and issues that diecty and indhrectiy impact on the nursing education landscape. Although the numberof chapters is the same 38 in the previous edition of the bool, we have modified some, replaced others and included new ones.$$ iv MBTI Mca. ‘MDG MEQ. MID NCHE NGO NIPF NOF NRF OBE, oHP OSCE PBL ge acto Re RCN RPL SAC SANC SANQF SAQA SSA sTTI UNESCO UNDP WBL WHA WHO www _Meyer- Briggs Type Indieator Multiple Cboice Questions ‘Mileaniam Development Goels Modifed nay Qpestons Measure of Itellctal Develop mission on Higher Eocation ne raise Naconal Industry Policy Framewer agonal Qualfeatons Framework National Reseach Foundation COuicomes-based Edveaton (Overhead Projecor - ‘Qujecve Structured Clinical Examination Problem-based Leatring Qualcy Counc | Guatiy Counc on Tacks and Occupations Revised Bloom's Taxonomy-based Learning Royal College of Nuesing,' [Retogaition of Prior Learning South African Medical Council South Afican Nursing Council South Afican National Qualifications South Aftican Qualifications Authority Sub-Saharan Africa Sigma Theta Tau Intemational ‘United Nations Educational, Scientific and Cultural Organiration ‘United Nations Development Programme Web-based Learning World Health Assembly ‘World Health Organisation World Wide Web [National Com [Non-Goxernm Framework CHAPTER1 Nursing, nursing science and nursing education “This book focuses on teaching and lesrning a applied to the eduction of ings 2 ring eduction, ad uring went The ems ‘ning and ning cc fen wd incl Bat hy he we meaning, of are the concepts diferet? The concepts ‘nursing’ and “nurtng A i Ged belne ucmng te deco ling the. Emenee The objectives ofthis chapter are t: + clay the concepts nursing’ and “nursing science’ dently and discuss the characteristics that make nursing unas + distinguish between education and traning scribe atleast Five characteristics of nursing education «list the key components ofa philosophy of nursing education 1 distinguish between two views relating to a philosophy of nursing education. Nursing ‘The word nursing’ comes from the Old French word norrice and the Latia tens matrix nuvicas and native all meaning ‘to nourish. Some of the tpeaniags ofthe ver to nurse, according tothe Chambers Teaenisth Century ‘Dictionary (1901), ae"to suckle’ 'to tend (an infant or sick person), bing ro manage with sil snd economy’ to play sifallymaniputs vito checarly keep wach in ruch wih i ode to obtain o preserve the se sed alt hold or cary To this the Cone Orford Dic sacs ond or promote the development of otf cr 95 ae ek psn vo manage With sbi and old or das simting ewes rom tase defnins that aucsing imples actions oF the perenne, Nang the everyday practice envionment or Ferm the antet in which using actions ae performed den by on ofthe daipline nd exiting evidence Is in performing ming Ln pce the surg process. Nursing therefore the Sat oder a ne of using a Yu ca ge in Figure 1.1 on page 9. Mele oie acct tha the dicpline of raring ‘incudes the content and ee ited to the les that nies play ech 6 ache administer, Tips, com sarche, and theo. ‘ial mow eure vomedeiition of pursing fom abl oguisatons thas hod nang and om inna indvidals chat have imputed on ring ovr decades Definition of nursing ‘When investigating the meaning of the term ‘nursing’ it i evident that che pad 1 clear definition has been a lengthy and challenging one, Nursing is tot stagnant science it develops and progresses. We can witness the evolving proce and effort encapsulate the essence of nursing fom the fist definition Pr the term to the 2003 International Council of Nurses (ICN) definition, which ie most widely used today. Florence Nightingales (1859) definition was probably the fst formal attempt to deseribe nursing: ‘what nursing bas ¢o fo... to pu the patent in the best condition for nature to act upon bi ‘While thc efnition does not embody every aspect and dimension of nursing, in essence its etl applicable in aursing to this day. The relevant aspects from the definition ae the promotion of health and healing the cure of an illnesy sand the interaction berween person, bealth and environment. a techn nanos hain ing emp define nursing. The mow widely aed deiton i probably Vins Henderson’ (1964) formulation, which expresses the nurs’ role and distinctive function as (0 sss, support or nurture the individual, who may be sick or well. The sole purpose of his ficon so conte oe health ofthe vidal ideally bi eee eae ‘can function independently ut any support IF the individual does not recover, the nurse supports @ Tesi foe osee be roe len oes zed denonsraesthar sheath mater fe. In cringthe patient i assited ig sponsibility forthe therapeutic teatmeat plan prescribed by the a onsne, nese siumex ane munsingeaucATION | 3 doctor. In pursing this proces, the nurse is part ofthe eultdiscipinary team, Sharing rexponsibities for patient care forthe improvement of helth recovery ‘Bom fineee or support in death, Evidently, Henderson was among the fist Fe he in nursing to consider the independent and interdependent role of {he musing practice and the curse as part ofthe culiisiplinay team. She wMiades to the murse~doctor relationship when she reiterates thatthe mar’ Fanction ~ not the doctors function ~ is to help the patent “Sine its inception in 1899 the ICN has provided several versions of the definition of nursing, which demonstrate the developmental nature of nursing, Te t987, the ION defined norsing as a central component of the healtheare ‘pete, with a focus om promotion, prevention an rextoration of health. This Gontion incarporated the continuum principe from birth to death (ll ages). Furthersnore, it paid epeciic attention to physial and mental nes, be i in ‘ hospital or community setting. The patent” could be an andiidual, 2 group ‘ora community “This definition’ contributions are: + atention to healthy and not only to sickness {aries include people from all ages and dierent ertings + The patient can bean individual a fasily ora comunity : ton that persons reace differently to actual health problems than ‘potzatial health problems. Since then the ICN (wworicn.ch) has adopted a shorter version of the ittion, which nevertheless continues to embody the core concep Usted above Nursing encompasses autonomous and collaborative cre of individuals Of all ages, families, groups and communities sick or well and in al atings. Nursing includes the promotion of health, prevention oF ines sea the care of il, disabled and dying people, Advocacy, promotion of arfe environment, researc, participation in shaping health policy and in patient and health systems management, and education are aso Key rursing roles ‘Atte Tnteroational Conference on Primary Health Care Alma-Ata, USSR, ee September 1978 the Declaration of Alma-Ata Highlighted Hes) SUA ty the year 2000 Tn elation to this declaration, the World Heath Ghganiaton (WHO) committed to swengthening nursing andl wider sernicesAccotding to the WHO (1991):Seemann atereenaeinem green aap cane TASES vgn society isto help Indivisual faites and The misono re Pe et Sa inhale PE TNS er | Fanatons that late tothe promotion and maintenance ofhealth as well functions nin of health. Nursing 10 neues the planning 25 fhe ron of cae ding ness ar rehab and ime ory mntal ard soil aspects of ey encore nes, daily and dying. Nursing isthe prowlon | are aida tlies and roupstroughout te ene We soon | rer death, Nuraig is oth an at and science that | requires the understanding and application of the knowledge and skills | | ‘rtf tothe dscipine also draws on knowledge and texnnaues speed trom the humanities and the prysical, socal, medical and biological sciences. Nussinghas evolved over the decades and theorists contiaue to clarify, analyse, dualuste and examine the constract ‘nursing’. The Royal College of Nursing RCN) (wwwrenorgak) generated a contemporary definition of nursing which adde a scence component of nursing thatis based on the nursing process ind requires the use of einical judgement inthe provision of nursing care. The ‘pec actives highlighted in di definition inches enabling, improving, ‘maintaining recovering, coping with health problems and achieving the best possible quality of life. Table 1.1 summarises the views of contributors in arempting to define nursing and their specific contributions. There do how te development of musing feds orbs Theis Sey ‘Taste 1.1 Contributors and their contributions to the definition of nursing Contributor Contribution (activites, characteristics and dimensions) Florence * Nuri : ursing is patientfocused Nightingale + Promotion ofheatth and heating + Cure ofan illness * Interaction - Interaction between person, health and environment iinia + identi terion | ite the nurse's roland distncte functions 1 pesos othe heath of the naval vidual to function independe * Nurse init my 1 AMS nats, supports and demonstrate care 1 aE part hemulscipinary team use delves patient care forthe impr orrecorey om tess or suppor indeatn Contributor ten wHO RCN Contribution (activities, characteristics and dimensions) ‘+ Nursing is autonomous and collaborative care {Focus ison individuals, Families, groups and commurities, «+ Includes all ages, from birth to olé age and death Sick orwell ‘© Includes all settings + Nursing is about: = promoting health = preventing liness = cating foil disabled and dying people = advocating. — promoting a safe environment = conducting research — patticipating in shaping health policy = influencing patient and health systems management — providing education «Nursing entails promoting and maintaining health, and preventing liness «Nursing includes planning and implementing nursing care during ll health and rehabilitation «© Nursing includes the physical, mental and social dimensions as they affect health, iliness, disability and dying, « Mursing means caring for individuals, families and groups +. Nursing includes the entire life-span —from conception 10 death ‘+ Nursing isan art and a science F ursing requires understanding and applying knowledge and skills “sNorsing is dvived from the humanities and the physical social, medical and biological sciences «= Requires nursing process Use of clinical judgement inthe provision of nursing care + Specific activities includ = enabling = Improving = maintaining = recovering ~ coping with health problems = Sehieving the best possible quality of fe 5cra dio of ing ttn we 9 many facets: However, the Following 3% Se seen pest sng pect (Melis, Brink Be Paton 1999, in cunce directed at providing 8 HUN hey a pies. requires kno iden tie die 9. nent ican Sg te et a high es nae fais Wh ae expand sng fom ase mal eas TA ane me ace Oe eonalie ca usb gen is concrned mah SOUS cate yg et aman Sf hose Neng cae Mir ay fear yeah apples the ousIng proce esa an art pieenaion eration and record ena sss ame cris and reabltatve, ong tenga 1h me rene a eaheae of PeDBE 0 hat they net tere rei atin and malvale O02 health, Where thet Smt mn pried co-ornaes the care given by tee ree et pesnreeing tat arto make the maximum, es enanng paentlan,iothe terminal stones of, to gt peace and wih gi ‘As nurse educators you should not expect students to know the defiiton by hears, but you should expect them to have an understanding of the cae activities, characteris or atbutes, processes, dimensions and purposes af pursing. Characteristics of nursing Mellsh, Brink and Paton (1998) definition combines the practicalities of cure wh indi Phnphy ~ th, sinus, pope oe nestle vad one goal the knowledge compare td kl sed on ier) ty ed inode oie Sere le SFL fe caro plo promote heath and prevent nes, ard tet na Te ie aan bg ih bso Yen eimai pet nt rpms Prat ide car ory abled and dying people. Wei alo t ieee ca NO ee Beards nt aos (Selamat tee teas ek sa at Mr gh Te a mae i pana re rey eg e i rae st ee Se fe ceaesae neato te at Ee ae amen pe Set mat aT paragon ogee pee ee competence and skills The art and scence of nursing’ based om fnoiedg erred fromthe various scence, that i, natural, biological fnd human scence. This ensures that nursing has a sientific foundation ‘A competency We more than just knowledge and sil. Iv involves the ability to meet complex demands by drawing on and mobilising resources {including skills and attudes) in a particular context. Shils ae not based fon knowledge; they are acquired ovee tne or teshnial in nature and do not form par of the art and science of musing Relationships: Nurses workin a tlationship wth patients, in partnership swith their relives and other carers, and in collaboration with others a8 ‘members of a multidiseipinary team. Actions that nuses perform as part of the team include leading, prescribing, delegating and supervising, At times nurses will participate under th leadership of anothes team member. Ceitcally they maintain professional telacionships and remain accountable for their decisions and ationsisa meaneto that end, thie me Nasi can end ia ‘need of care. We muse 8 met Tam bees a eo hae Se at complement the at The et a randerstandable partnership, Tn op"? thay ing portant understand the os Science coal meDisoney oneaamscqusieonin goth Ma ey of human beings andthe, isla nd mth and inferences made. From dhe | ei, based ulated based of observations and meagre) eal ies 8 sion. Ths definition forms the nae eee ‘ bane aa raat ah sence dssplines. Several degree p hin BET mor ever se Loar Snte eesti kroW” Parc (1997.64) dena King 9 Santon ofthe subject of inguiy and the meses cer rig kong in dscpine Ths, sence sb {ices a we ome 0 gh aie conceptalization ada eee ionen 20251). Buns and Grove (2005:13) suggest the it Tosa bad of owldge composed of research findings aac thoi fr aspect pine = Soc, oF sti knowledge, cepresents our est eflts tm lcoeing th Is open-ended evolving and subject to reuse weal nfs in dramatic shift ia thought (Bertert 2002), hen (202) father rposs ha eserch is how we create science Rea is asysterticenpiy that wes dicplined methods to answer quetien she pblns eine plofseeneh ee lee spel rt goof wach devel reine i op ‘te aay Pl Beck 8 Hanger 2001) and there Nursing science Although nazses a liar wf comple li ith this concepr, it eemains a challenge toi! toinclade al. ieclga such a definition must be broad et Barer 260) Ni? Bohl and cane focus on oly one pt Cane ia Fguc 11 the second order ofthe discipline #7 2 do so. By 1900 profesional nursing education ha been vel eee by the efforts of Sister Henreta and others. Although ot eoeeatcr see ‘Medical and Pharmacy Act of 1891, such training was reserved for whites only AS a consequence thee were no qualifed tack proseral wee until 1907, when Cecilia Makiwane registered as the first black professional nase in South Afi. Vitoria Hospital at Alice wit the hes te seg Wine Professional nurses between 1903 and 1930, under the leadership of the ‘medical superintendent, Dr Neil MacVicar, and the matron, Miss ‘Mary Balmer (Mashaba 1995). Although the training programme at the time had a strong domestic component, nurses were caefilly selected to sit for