Dr. T. Kim Rodehorst

Associate Professor

University of Nebraska Medical Center

College of Nursing

What a Concept! Considering a Move to

Concept Based Teaching

Definition of termsPresent current research on the benefits of

concept-based teachingShare experiences related to changes in

students' clinical judgment after moving to a concept-based model

Provide tips, best practices and common objections to those considering a concept-based teaching approach

Objectives

I. Overview of Concept-based Learning in Nursing A. Defining concept-based learning B. Impetus behind growth in concept-based curricula C. What it means to teach conceptually II. Planning a Move to a Concept-based curriculum Considering the Concerns of Traditionally-minded Colleagues Best Practices for Planning for a Concepts Curriculum Sharing Concept-based Curriculum Change Experience at UNMC

III. Results from Moving to a Concept-based Curriculum Changes in Classroom Teaching Changes in Student Learning Experiences 

Overview

What Is Concept Based Learning

Erickson (2008) identifies five criteria that concepts need to meet. Concepts should be:

broad one or two words universal in application timeless represented by different examples that share

common attributes

Concept Criteria

A concept is an abstract or generic idea generalized from particular instances (Erickson, 2008).

A paradigm for learning that classifies essential content into categories

Concepts are taught through use of exemplars.

A way of learning that prepares students to function in our ever changing health care system

Creates higher order thinking, which assists learners to discern patterns and inter-relationships (Thomas, 2000).

What is concept based learning

Impetus for Change

Many forces affecting the educational process

Knowledge explosion

Technology

Changes in health care with emphasis on prevention

Persistence of faculty to teach increased amount of information in the same manner

Characteristics of our learners have changed

Impetus for change

"call for equally profound changes in the education of nurses and the preparation of nurse educators," …..the redesign of nursing education as "an urgent societal agenda.“—Carnegie Foundation,2010

"interactive, and innovative programs and curricula should be designed to promote leadership in students, develop students' thinking skills, reflect new models of learning and practice, effectively integrate technology, promote a lifelong career commitment in students, include intra- and interdisciplinary learning experiences, and prepare students for the roles they will assume”---NLN, 2006

“The ways in which nurses were educated during the 20th century are no longer adequate for dealing with the realities of health care in the 21st century. As patient needs and care environments have become more complex, nurses need to attain requisite competencies to deliver high-quality care”—RWJF, 2008

“Current type of teaching/learning is ineffective in the current complex health care settings “—IOM, 2010

A Call for Change

What Does It Mean To Teach Conceptually And

Why Is It Important

Helps students gain a deeper understanding Helps students be able to generalize from one

situation to another Enables students to create bridges between what

they currently know and what they can learnAllows students to start to see patterns and to

use those patterns to think about the facts they know

Helps students make connections between other related subject areas

What does it mean to teach conceptually and why is it important

A goal in this type of learning is to build a conceptual understanding of nursing that will be transferable to future knowledge and developments in a variety of related client-care situations

What does it mean to teach conceptually and why is it important

Planning The Move To A Concept Based

Curriculum

DO YOU REALIZE HOW LONG WE HAVE BEEN TEACHING THE SAME THING THE SAME WAY

Recognize that there will be resistance Faculty need to see themselves as a personal

trainer

Know that there is not one list of concepts, nor is there only one way to teach them

Be open to change and know there will be challenges

So How Do We Move To This Model?

Faculty are very comfortable with teaching in the traditional style

Faculty are used to teaching in a very linear fashion

Faculty may not be comfortable teaching with a more general scope

Faculty may not feel comfortable helping students transfer knowledge

There will be a tendency to go back to what is familiar

Challenges To Concept Based Nursing

Students are very comfortable with learning in the traditional style

Students are used to learning in a very linear fashion

Students may not be comfortable learning in a more general scope

Challenges For Students

Suggested Process For Implementing A Concept Based

Curriculum

1. Identify and define the concepts2. Categorize the concepts3. Identify conceptual lenses (or subcategories)4. Identify generalizations5. Specify performance outcomes6. Specify critical or essential content7. Identify topics or exemplars that best depict the

concept8. Identify learning strategies9. Connecting the process for the “big picture”Erickson, H.L. (2008). Concept based curriculum and instruction for the thinking classroom.

Thousand Oaks, California: Corwin Press

Suggested Process for Implementing Concept-Based Learning

Pediatrics: ProtectionMyelomeningoceleGastroschisisOmphalocele

Adults: OxygenationARDSRDS

Pregnancy: MetabolismDiabetes during pregnancyDiabetes in childrenDiabetes in adults

Example of teaching conceptually

Our Experience With Moving To A Concept Based Model

Moved to a concept based program 2 years ago.Identified concepts and defined conceptsCategorized concepts under our “old”

organizing frameworkHealth promotion first semesterAcute careChronic careComplex care

Course groups then developed the coursesEach campus determined their own way to

implement the concepts.

Our Experience With Concept Based Curriculum Change

Required to develop more active teaching strategies

Faculty “buy in” not completeFaculty dealt with content overload by not

including sufficient content on the specialty areas

Some faculty “got it” and were able to integrate the concepts in very unique ways, and utilized active learning strategies appropriately

Others remain the talking head and had difficulty making the change

Other Confounding Issues

Informal formative evaluation via blogs and threaded discussions.

Most were able to see how the conceptual learning was a far better method that would serve them well.

This was somewhat dependent on how the course was taught.

Some students complained about not knowing anything and feeling like an” experiment”

That too seemed to be somewhat dependent on the attitude of the course faculty

Students Perspectives

Informal formative evaluation provided to faculty via blogs and threaded discussion.

Mixed evaluation—some have bought in and others are still loathing the change.

General consensus that there has been a loss of specialty content—peds, ob, psyche—which has had an impact on our faculty

Changes have been made based on above feedback

We have graduated our first cohort this past May

Faculty perspectives

Perhaps this quote is applicable to contemplating the change of moving to a concept based curriculum…..

It is not the strongest of the species that survive, nor the most intelligent, but the one most responsive to change.~Charles Darwin~

Benner, P. (2010). Educating Nurses: A Call for Radical Transformation, San Francisco, CA: Jossey-Bass.

Erickson, H.L. (2008). Concept based curriculum and instruction for the thinking classroom. Thousand Oaks, California: Corwin Press

Giddens, J., Brady, D., Brown, P., Wright, M., Smith, D., & Harris, J. (2008). A new curriculum for a new era of nursing education. Nursing Education Perspectives, 29(4), 200-204.

Institute of Medicine. (2011). The future of nursing: Leading change, advancing health.Washington, DC: National Academies Press.

Ironside, P., & McNelis, A.M. (2011). Optimizing pre-licensure students’ learning in clinical settings. Nursing Education Perspectives, 32 (1), 64-65

Pearson Education. (2011). Nursing: A concept-based approach to learning (Vol. 1 & 2). Upper Saddle River, NJ: Pearson.

Schmidt, D.L., Saigo, B.W., & Stepans, J. (2011). Conceptual change model. St. Cloud, Minnesota: Saiwood Publishers.

References