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81

Constructing a Concept Map

Learning Objectives• Identifyanddemonstratethenecessarystepsforcreatingaconceptmap• Discusshowconceptmapping theory is evidentwithin theproblem list and

completeconceptmap• Explainhowconceptmapformattingdemonstratesrelationshipanalysis• Analyzeandexplainhowproblemidentificationdefinesnursingactions

IntroductionInformationprepared forusewithinaconceptmap is important.There isnodoubtaboutthatandindeeditispartoftheprocess.However,collectionisonlypartoftheprocess.Itistakingthatinformationandplacingitwithinaconceptmapthatgivesitmeaning.Placinginformationintoamapbreatheslifeintoit.Separateandisolatedfactsformassociations,clarifyconcepts,andarevaluabletoanalyzeourthoughtprocesses.So,formattingandlayoutareasvaluableaswhattheconceptmapcontains.Thesetwocomponentsallowastorytoflowdemonstratingthefactualinformation,howitrelatestomainandrelatedconcepts,andhowitleadstoactions.Thebonusresultisthatspe-cificthoughtprocessesaremappedoutaswell,providinginsightintoabilitiesreflectingjudgment,decisionmaking,andapplyingknowledge.

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82 CHAPTER 5 | ConstructingaConceptMap

Whilethepurposeofthistextisanemphasisonnursingapplications,let’sfirstcon-sideranonnursingexample.Conceptmappingtheoryplacesagreatdealofemphasisonforminglinksandassociationsbetweenconcept.Manytimes,thiscantakeplacemoreeasilyatfirstwhenassociationsaremadeusingfamiliarconcepts,examples,andexer-cises.Fromthere,wewillmoveontonursingexamples.Theseexampleswillreinforcetheinclusionofpreviouslylearnedmaterialsintonewertheorytoallowustocomparewhatwehavelearnedtohowitcanbeusedaspartofpatientcareandnursingactions.Thislayeringofinformation—blendingpastwithcurrentknowledge—isnecessaryinthetheoryapplicationprocess.Formattingtheconceptmapswillpullallofthistogether.Itwillalsogiveyougreatinsightintothedegreetowhichyoucancriticallythinkandmakeassociationsbetweenconcepts.Attheheartofconceptmappingtheoryisapplication:takingwhatyouknowandwhatitmeansintermsofdefiningactions,anticipatingpatientneeds,andconsideringcauseandeffect.Youwillusethisknowledgeinexactlythiswaythroughoutyournursingcareer.Nowisthetimetoestablishanexpansivedatabaseofknowledgeand,additionally,thecriticalthinkingthoughtprocessesthatassistyouinapplyingit.Thischapterappliesconceptmappingtheory.Italsoaffordsanopportunitytodelvemoredeeplyintoknowledgeapplication.

Key Terms and Definitions• Nursing-based concept maps:conceptmapscontaininginformationbased

onapplyingnursingknowledgethroughanalysisofskillsandnursingcare–relatedactions

• Concept map formatting:physical layoutofconceptmapconstructiontodemonstratecriticalthinkingandrelationshipanalysis

• Learning continuum: theprocessof learning thatbeginswithattainingsimpleknowledgeandcontinuestocomprehensionandultimatelyapplication

• Concept map uniformity:useofonestylethroughoutaconceptmapforclarityandinterpretativeease

• Open copy templates:blank,pre-formattedconceptmapsadaptedtoastu-dent’spreferencesbasedonlearningstyleandmentalprocessing

• Symmetrical concept map formatting:balancedsymmetrywithinacon-ceptmapforvisualappealandinterpretation

Setting Up a Concept MapNowthatyouhaveanideaofwhatabasicmaplookslike,weneedtoexplorehowtosetoneup.Wewillusealloftheinformationwehavegatheredtoselecttherequiredcomponents and startingpoint.Remember,each step is simple inandof itself. It issometimestheconstructionpartthatgetsconfusing.Wewilladdressthisanditwillbecomeclearer.Iwillbeginwithanonnursingexamplethatanystudentcanrelateto.Thisallowsforaneasierbeginning,becausewearedealingwithsimpleandeasyrecallofacommonsituation.Therearemoreknownfactsthanunknownones,whichmakesproblemidentificationandrelationshipanalysisabiteasier.

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SettingUpaConceptMap 83

Usinga familiarexamplemakes foreasier linksandtheability toseewhereeachappliesandfitsintoourfinalproduct,whichisacompletedconceptmapclearlydem-onstratingconceptmappingtheoreticalcomponents.Proceedinginthiswaymaymakeiteasiertotransitiontoanursingexample.Althoughthefollowingexamplecouldbeexpanded,wearegoingtokeepitsimpleforbetterdemonstration.Inanygivensituation,thereisapossibilityforalargenumberofproblemsorconsiderations.Wewilllimitthelisttoaboutfiveconsiderations.Let’ssaywearehavingourrelativesoverforaholidaymeal.Wewillcreateamapfromthatscenario.

Step 1Ask: Whatisthemainconcept?Whatareother,smallerconceptsthatrelateinsome

waytothemainconcept?Do: Createalistwiththemainconceptastheheadingandtherelatedconcepts

listedbelowit.

Oneofthemostconfusingelementsforstudentsisthecreationofthis list,espe-ciallywhenresearchrelatedtoitscreationinvolvesabstractconcepts.Whatyouhavetorememberisalllearninginvolvingnursingtheoryprogressesalongacontinuum.Thatlearning continuuminvolvestakingknowledgeandanalyzinghowitfitsintowhatwaspreviouslylearnedandmakingassociations.Becausetheprocessbecomeseasierandclearerwithmoreexposuretoknowledgeandexperience,creatingtheproblemlistwillbecomeeasierovertime.Amajorstepinthisprocessistouselinksandassociationswithalllearningandstudying.Linkingandassociatingconceptswillensuremoremeaningfullearningandenhancecriticalthinkingskills.

Themainconceptisusuallyveryclear,dependingonthemap’sfocus.Thelistofrelatedconcepts requires somedeeper thoughtprocessesandmay stymyyouatfirst.Reviewoftheoryorskillknowledgemayberequiredforaccuracyandcompletenessofthemap.Instantrecallofpreviousknowledgeoccurswithrepeatedexposureandprocessingofit.Althoughthismaybeviewedastimeconsuming,itisinrealityapartofthewholeconceptmappingtheorydescribedearlierinthetext.Asanyeducatorisaware,repeatedexposuretofactualknowledgeaidsinthecomprehensionprocess.Asstatedearlier,com-prehensionisessentialifprogressiontoapplicationcanoccur.Also,becauserelationshipanalysisisamajoringredientintheprocess,simplythinkingaboutwhatrelatedconceptstoincludeandhowtheymightfitisabigstepinstimulatingthecriticalthinkingspark,whereonequestionleadstomanymore.

Relatedconceptsmayfurtherbesubdividedintoprimaryandsecondaryrelatedcon-cepts.Primaryconceptsusuallyhaveamoredirectrelationshipwiththemainconcept.Theyarenecessarytodirecttheactionsthatwillbetakennext.Often,secondaryrelatedconceptshaveanindirectconnectionwiththemainconceptbutarestillimportanttotheactionstaken.Separatingconceptsintothesecategoriesassistswiththeanalysisprocessandreinforcesconceptualinformation.

So,weknowthatourmainconceptisthedinneritself.Easy,right?Nowvisualizethesituationasifitwerereallyhappeningandyouwerehostingthisget-togetherinaweek.Next,thinkofeverythingelseyouwillneedorneedtoconsiderthatrelatestohavingadinnerforagroupofpeople.(Note:ifyouaredoingthisexercisewithaclass,

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youmaywanttolimitthelisttofivethingsbecauseoftimeconstraints.)Yourlistwouldlooksomethinglikethis:

Dinner Party

• Numberofguests• Menuandcourses• Invitations• Specialdietaryneeds?• Supplies

Asyousee,onceyoustartthinkingofthings,manymorepossibilitiespopintoyourhead.Youmightchooseotherconsiderationssuchastimeofdaytohosttheevent,thedinnertheme,beveragesupplies,whethertoservealcoholicbeveragesornot,andseatingarrangements.

Oncethishasbeencompleted,takeamomentortwotodeterminewhatinterrela-tionshipsexistontherelatedconceptlist.Wecanimmediatelytakenotethatthesuppliesweneedandthenumberofinvitationsnecessarydirectlyrelatetothenumberofguests.Anyspecialdietaryneedsamongthegroupofguestsdirectlyrelatetothesupplies,aswellasthemenuandcourses.Beingawareoftheserelationshipswillhelpwhenwebeginplacingthedataintotheshapes.Itwillhelptoeitherrecordtheseextensionsoftherelatedconceptsalongsideeachoneorcreatesmallboxesneareachonetoestablishrelationshipsandtopreventomittingnecessaryinformation.Writingitoutinthiswayallowsyoutoseetheinterconnectednessofeverythingneededtoplanandhostasuccessfuldinner.Ifnotallrelationshipsareclear,youwillwanttoeitherdrawlinesorcolorcodethecategories.Thiswillmakeyouthinkthroughhoweachfactorislinkedtoreinforceit.Thiswillbeespeciallyhelpfulwhenyoubegintocreateanursing-based concept map.Asyouprogressinthisprocess,youwillbegintolookateverythingyoulearnandencounterclinicallyashavinganassociationor interrelationshipwithsomethingelse.This is an important goal to set for yourself.

ThefirstlistyouseeinFigure 5-1isagenerallistingofthemainandrelatedconceptlist.Theleft-handsideofthechartwouldbeconsideredthemainproblemorconsider-ationconcepts.Theremainderofthelistwouldsignifytherelatedconcepts.

Figure 5-1 Main and related concept list for the dinner party example.

Dinner Party

Main List

Numberofguests Consider:seatingarrangements,relationshiptohost,facilitysize

Menu/courses Consider:specialdietaryneeds/restrictions,preptime,cost

Invitations Consider:design,numberofguests,postagecosts,mailingdate

Specialdietaryneeds Influencesingredients,menu,andcosts

Supplies Consideraboveinformationplustabledecoration,favors,placesettings

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Beforeweproceed,let’stakethelistandidentifyrelatedconceptsaccordingtotheirprimaryorsecondarystatus(seeFigure 5-2).Thenwecanbegintothinkaboutactionsweneedtotake.

Asyoucansee,eachtimeyouconsideraproblemarea,therearemanythingsyoucouldthinkofinadditiontowhatislisted.Let’snowfocusonthelistwehavecreated.

Dinner Party Guests

Thisisthemain,determiningfactorfromwhichallotherconsiderationsoriginate.Thismainconcepthashelpedustoformulatetherelatedcategories.Theguestsarethefocusofthepartyandthebasisforactionstakeninplanningtheevent.Thus,anassociationhasbeenmadebetweentheguestsandtherelatedconcepts.

Number of Guests

Ourguestlistisavitalpartofplanninganddecisionmakingrelatedtocost,seating,andallotherorganizationalplanning.Thespecificnumberdecidesoverallcostandnumberofsuppliesneeded.Theotherimportantassociationtomakeisthathavingknowledgeoftheguestswilldeterminetheparty’ssuccess.Althoughthisimpactsmanythings,I

Figure 5-2 Organizing related concepts into primary or secondary status.

Number Cost, room/facility size, seatingarrangements, relationship tohost/hostess

Menu choices Presentation, place settings cost,ingredients, preparation time

Invitations Cost, mailing schedule, RSVPinstructions, postage, design

Dietary considerations Knowledge of guests’ dietary needs/restrictions, cost, inclusion ofnutritional information

Supplies Groceries, beverages, place settings andsilverware, cost, table decorations,favors

Main concept:

Dinner party guests

Primary relatedconcepts

Secondary relatedconcepts

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haveisolateddietaryrestrictions.Notconsideringguestdietaryrestrictionscouldleadtoallergicreactions,reluctancetoattend,orevenagreatdealofleftoverfood.

Preliminaryactionsrelatedtoalloftheinformationgatheredcouldinclude:

• Settingupabudget• Callinggueststoaskaboutfoodpreferencesandanydietaryrestrictions• Planningatimebudgetforfoodpreparation• Preparingtablecardslabeledwithnutritionalinformationofthefoodserved

So,alreadyinthefirststep,wearethinkingaboutpossibleactionsandmakingassocia-tionsbetweenthemandourlistofitems.

Usingaformaltoolsuchasacollectiontooloraninformaltoolsuchasapieceofnotepaperandrecordingtheproblemorconcernasyouresearchisagoodplanforarudimentaryproblemlist.Oncethathasbeencompleted,youwillthenrefinethelistaswedidhere.Nomatterthemethod,besuretobegintomakeassociationsimmediately.Youcanincludenotesforeachcategory,encloselikegroupingswithincircles,ordrawatypeofcharttobeginmakingassociations.Again,Ihavetoemphasizethatbecauseeveryoneassimilatesandmentallyprocesses informationdifferently,chooseamethodcongruentwithyourlearningandmentalprocessingstyle.Somegeneralizedquestionstoaskduringthisprocessare:

1. Whatconceptsorthingsrelatedirectlytothemainconcept?2. Whatconceptsorthingsrelateindirectlytothemainconcept?3. Ifalinkisidentified,inwhatwaysisthatlinkevident?4. Inwhatwaysdotheitemsontherelatedproblemlistsassociatewithanddif-

ferentiatefromeachother?5. Howdocauseandeffectplayaroleinmakingassociations?

Inordertofullyteaseoutthespecificassociations,itwillbenecessarytoaskspecificquestionsaswell.Somespecificquestionsforthisscenariomightbe:

1. Howiscostaffectedbyguests’foodpreferences?2. Howmanyvarietiesoffoodsarenecessarybasedonthosepreferences?3. Whenshouldtheinvitationsbesentoutsothatthereisenoughtimeforguests

toRSVP?

IneachpartofStep1,wehaveusedcriticalthinkingandrelationshipanalysistoidentifyconceptsandanticipateactions.Thesameprocesswilltakeplacewithinnursing-basedconceptmapproblemlists.

Step 2Ask: Whatshapescanbeusedandwhatgoesineachone?Do: Begintoplaywithvariousformats,beingsurethemapislegible.

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Ingeneral,thereisnolimittothenumberofshapes.Itismuchbettertohavemoreshapeswithlesscontentineachthantoomanyconceptslumpedtogetherinatoolargeshape.Usingmultipleshapesallowsformoreeffectivedefinitionofconceptsthroughisolation,makesforacleanerandmoreorganizedappearance,andisaformatthatbetterdemonstratesthepathofyourconceptmap.Itisawonderfulideatopracticeaswepro-ceedformaximumbenefit.Youmayindeedcomeupwithadifferentrelatedconceptlistandusedifferentshapes.Thisiswhereyourcreativityandlearningstylecomeintothepicture.Havingsaidthat,ifyourlearningstylehasastrongverbalfocus,placingsmalllistsorevenoutlinesintoamapmayworkbetterforyou.Forthemorevisuallearner,clipartmayworkbetter.(TouseaConceptMapCreator,seetheStudentCompanionWebsiteathttp://go.jblearning.com/schmehl.)

Asyoubegintopracticeandtryoutvariousformats,paycloseattentiontoyourfor-matting,includingallbasiccomponentsandavoidclumping.Itmayevenbehelpfultosimplydrawshapesfirsttoseewhichyoulikebest.Then,youcanadjustlayoutandseewhichoneslookbest.Forinstance,Figure 5-3showssomepossiblepreliminarylayouts.

TheleftsideofthediagraminFigure5-3showsaclearinformationpathwayandclearlinks.Therightsidehasachaoticandjumbledappearancethatwouldbedistractinganddifficult,ifnotimpossible,tointerpretandfollow.Whenformatting,oneofthegoalsistoshoweachstepinyourthoughtprocess.Thisestablishesaclearpathwaydemonstratingtheuseofcriticalthinkingthoughtprocessesandcanbeusedasareflectivetoolaswell.

Step 3Ask: Whatdescriptivephrasesandlinesworkbestwiththerelationshipsyouwant

todemonstrate?Do: Uselinestolinkallconcepts.Do: Chooseactionphrases.Do: Experimentandfindthosethatbestfitwithwhatyouwanttoshow.

Ifyoudrawablank,gobackandreviewtheprevious informationondescriptivephrasesandrememberthateachphraseisdescribinganactionyouhaveeitherperformed

Figure 5-3 Desired versus undesired layouts.

Desired layout Undesired layout

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orplantoperform.Thephrasesassistyouwithdemonstratinghowyouhavelinkedapieceofknowledgewithanecessaryaction.Youcanpractice thisonpaperorwhileprovidingcare.Let’sassumeyouarecaringforapatientwithanewfindingofhypoten-sion.Asyourecognizethatthisisanabnormalfinding,yourmindshouldbelinkinganaction.Examplesofthethoughtpatternsandpossiblelinkingphrasesfoundbelowwillbeusefultothinkthisthrough.Puttingallthoughtsinsentenceformisanothermethodtohelpreinforceinformationandtounderstandhowyouwould“say”thesamethinginaconceptmap.

1. New hypotension can lead to dizziness so my action is to monitor for orthostatic vital signs and institute safety measures.Thephrase“canleadto”connectsyourrecognitionofhypotensiontodizziness.Useofthephrases“monitor”and“institute”includessafetyconsiderationsandtakesyouractionsastepfurther.

2. My patient’s blood pressure is 98/45, and this is a new finding. I will need to notify the RN and assess the patient for symptoms.Thefirst statementdemonstrates recognitionof anabnormalfindingaswellascomparativeanalysisof thepatient’sotherbloodpressure resultswith thismeasurement.Thedescriptivephrase“notify” indicatesactionsrelatedtocol-laborativecarearechosen.Additionally,itdemonstratesthatyourecognizeyourownpracticelimitations,thatthephysicianwillbenotified,andthatneworderswillmostlikelybereceived.Finally,choosinganactionto“assess”thepatientdemonstratesyourknowledgeandcriticalthinkingareleadingyoutoanticipatesymptomsandthepossibleneedforfurthernursingactions.

3. My patient has a hypotensive blood pressure. Before I administer these antihyperten-sive medications, I will need to assess for any hold parameters and then recheck the blood pressure prior to administration.Severalmeaningful information links areevidenthere.Critical thinkingandrelationshipanalysishavebeenusedtorecognizethelinkbetweenhypotensionandadministeringtheantihypertensivemedications.Inaddition,pastexperiencewiththesemedicationshascreatedanawarenessofholdparameters.Thephrases“needtoassess”and“recheck”reflectthesethoughtprocesses.

Thetypeoflinesyouuseneedstoconnectallproblems,relatedconcepts,andactions.Thelinesaretheroadways,sotospeak,andassistwithdecipheringtheconceptmapandthepathyourthoughtprocesseshavetaken.Theyhelptoshowinterrelationshipamongandbetweenconcepts.

Step 4Ask: Whatlayoutdemonstratesaclearflowofinformationandmakesthestatement

Iwant?Do: Fillinthelayout,andthenreviewforclarityanduniformity.

Thisiswhereyouwillreallyputyourlearningstyleandbraintowork.Yourbrainhasalreadyabsorbed, investigated,categorized,andorganizedtheinformationunder

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ConceptMapFormattingOptions 89

consideration.Nowtheinformationmovesthroughyourbrainandbecomesapatternofthoughtprocessesthatthenmovetoyourhandswhereyouwillexpresswhatyourmindsees.Whileyouabsolutelyneedtohaveclear,in-depthknowledgeofyourlearningandbrainprocessingmethods,pleaseknowthatformattingmaynotcomeeasilyatfirst.Thinkingthroughsomethingandthengettingthatinformationontopaperinalogicalformatisnotalwayseasy.Althoughyoumaythinkthiswayandcarryoutactionsthisway,thereisacertaindegreeofdifficultyatfirst.Youneedtoworkatitandtuneintohowyourbrain“sees”sothattheflowofinformationmakessense.AsIstatedearlier,thisprocessissomewhatlikereadingsymbolsorthinkinginadifferentlanguage.Ittakestimeandpractice.Moststudentswillchooseapatternandthencontinuetouseit,maybewithslightvariationsattimes.Othersmayexperimentoverseveralweeksuntiltheyfindaformatthatworksforthemandfeelscomfortable.Pleasedonotgetdiscouraged.Theworkyouputintothisprocessnowwillmostdefinitelyreaprewardslater.Giveittime,bepatientwithyourself,seekhelp,andabovealldonotgiveup.

Beginwithoneconceptatatime.Chooseashapeforit,adescriptivephrase,andlinestyle,andthenlinkittothemainconcept.Repeatthisprocessuntilyourmapiscomplete.Continuetomakeassociationsasyougo,justasyouhavedonewhencreatingtheproblemlist.

Onceyoufindalayoutformatthatflowscongruentlywithyourlearningstyle,youmaychoosetokeepanopenorblankcopyofitforuseinotherprojects.Theseopencopytemplatesmayneedalterationswhenusedinlivingmaps,butcanbeusedasisforstaticmaps.

Open copy templatesusuallyincludeshapesandformattingstylesthatarepleasingtotheeyeandflowaccordingtohowyourbrainseesandprocessesinformation(touseaConceptMapCreator,seetheStudentCompanionWebsiteathttp://go.jblearning.com/schmehl).Thebenefitisthattheylendthemselvestoavarietyofusesbecausetheyarepersonalized,andallyouwillhavetodoisfillintheblanks.Theycanbeusedandstoredoneitherpaperorviaelectronicmethods.Formattingwillchangelittlewhenusedasastaticmap.Atthesametime,addinginformationwhenusedaslivingmapswillbeveryeasybecauseyouwillusethesameformatting.Any“addon”informationwillsimplybeanextensionofthetemplate.

Concept Map Formatting OptionsInthissectionyouwillfindseveralvariationsofconcept map formattingbasedonthedinnerpartythemeweexploredearlier.Yoursmaylookdifferent,andthatisfine.Remember,yourpersonallearningstyleandhemisphericbraindominanceinprocessinginformationisahugepartofhowyouseethattheflowlooksasitshouldtoyourmind’seye.Youwillknowwhenitlooks“right.”Then,aslongasitdemonstrates relationship analysis, contains all the components of a basic map setup, and is legible and uniform,yourconceptmapwillhavevalue and meaning.Valueandmeaningbecomeevidentasyoufollowthepathwaysofyourmap.Ifyoutakeyourfingerandtraceitalongtheshapesandlinesofyourmap,criticalthinkingandrelationshipanalysisshouldbeevident.Thisisappliedconceptmappingtheory.

However, this is notwhere everything ends.The end result of anymap—whatappearsonthepaperinfrontofyou—isadirectresultofyourthoughtprocesses.Itisadirectexpressionofhowyoutooktheinformationinandthenprocessed,separated,

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andcategorizedittocreatethatmap.Itbecomesawindowintoyourmindandhowitproblemsolves.Whenyouarefinishedandarestudyingyourmap,askyourselfthefol-lowingquestions:

• HaveIbeenabletoseeandincludeallnecessaryinformation?• DidIaskenoughquestionsanddemonstrateallthenecessarystepsneeded—

whethertheyareskillornursingactionrelated?• IfIdidnotaccomplishtheabovetwogoals,whynot?

Thisevaluationisaformofreflectionandabsolutelynecessaryinnursingpracticeandnursingeducation.

Asyoumovebeyondcreatingstatic mapstocreatingliving maps,youwillbeabletousethatinsighttoassessyourcriticalthinkingskillsastheyapplytocomplexpatientsituations.Conceptmapsarebarometersofcriticalthinkingability.Thefinishedproductallowsyoutoreflectonyourperformanceandassessyourabilitytoapplyknowledge.Fac-ultycanassessclinicalcompetencyinadditiontousingeachmapasateachingtoolatthesametime.Mapsareawonderfultoolforprovidingfeedbackandguidingstudentstowardattainmentofcompetenciesandacceptablepracticestandards.Anextremelyimportantcomponentinfacultyevaluationofstudentmapsisfeedback.Icannotstressthatenough.Studentself-assessmentpairedwithconstructiveandregularlyprovidedfacultyfeedbackserveasreinforcementofperformanceandcompetencyfulfillment.

Formattingcanbecarriedoutmuchmore smoothlywhen there is anawarenessandapplicationofyourspecificlearningstyle.Knowingyourlearningstyleisimportantbecauseitwillpointyouintherightdirection.Ifyouliketoexaminepiecesofinformationfirst,yourmapmayshowamainconceptinthemiddleofthepaper,surroundedbyshapeswitharrowspointingbacktoit.Ifyouliketoconsidertheoverallconceptfirst,yourmapmightshowashapeatthetopofthepagewithrelatedconceptsfanningoutfromit.Onestudentmightsetupamapwiththemainconceptorproblemsetontheleftsideofthepagewiththeflowofinformationextendingouttotheright.Anothermaychoosetoplacethemainproblem/conceptinthecenterofthepaperandthengrouprelatedconceptsinsmallclustersineachcorner.I cannot reiterate enough that there is no right or wrong way in map formatting as long as concept mapping theory is evident.Tobecomebothproficientandcomfortablewiththisprocess,youneedtopractice,practice,practice.

Asyouexperimentwithvariousformattingstyles,besuretouseapencilratherthanapenormarker.Usinglargersizeddrawingpaperoraposterboardwillgiveyoumoreroomtopractice.Anotherhelpfulhintistousesmallpiecesofpaperonwhichyouhavewrittenyourconcepts/lists.Youwillthenbeabletomovethemaroundtofindwhichlayoutworksbest.Youwillfindthatalthoughpracticeiskey,knowingyourcontentisessentialaswell.

Figure 5-4 issetupinasortof“T”shapewherethemainconcept iscentrallylocatedanddifferentiatedbycolorandadifferentshapefromtheothers.Ihavealteredthemainconceptabittooverallplanningofthepartyandnarroweddowntherelatedconceptsbecauseofspaceconstraints.

Thethreemainrelatedconceptsareoutlinedingrayandarethelaunchingpointforadditionalrelatedconceptsimportanttotheproject—signifiedbythecyanboxes.Inter-relationshipsbetweentherelatedconceptsaredemonstratedthroughplacementofthecyanboxesagainsteachother.Thisdemonstratesandreinforcestheirlinkstoeachother

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aswellas themainconcept.Descriptorsarehighlightedandconnectthemainfocustotherelatedones.Arrowsshowdependentrelationships,andtheboldblackoutlineonthelowerboxstressestheimportanceofconsideringthis informationwhenplanningtheparty.Overall,thisstylelooksfirstatthemainconceptandthenathoweverythingelseaffectsit.Althoughitissomewhatsimple,allthecomponentsofconceptmappingtheoryareevident.Thismapisfairlyeasytoreadandinterpret,buttheincludedkeyishelpfultoreinforcetheconnectionsmade.

Anotherthingthatstandsoutinthismapissymmetry.Thoughsymmetryisnotessentialtoformatting,itmaymakethemapappearbalancedandemphasizecomparisonandcontrastwithintheconceptmap.Becauseonegoalofmapformationiscreatingapathwayofinformationthatflowseasily,symmetrymayaidthatprocess.Usingbalanced,symmetrical concept map formattingmayalsobemorepleasingtolookat.Justrememberthatthecontentofthemapiswhatcounts.Itisnotsupposedtobeagrandworkofart.Symmetricalstructureinaconceptmapmayappearasbalancedclustersof

Figure 5-4 Formatting example 1.

Dinner partyplanning

Create

Menu

Based on

Guest #

Buy supplies

Determine

Allergies and specialdietary

needs/preferences

Invitationsneeded

Timetablefor mailing

andRSVP

Courses

Prep timeand cost

Thisdetermines

This helpsto plan

Main concept

Map key

Related conceptsDirect relationships betweenmain and related conceptsRelationships between andamong related concepts

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informationspreadoutovertheentiresheetofpaper(oftenineachcorner)orasdividedsegmentsofinformationinhalvesofthesheet(topandbottomorleftandright).Often,thisisnotintentionalbutpartoftheexpressionofthoughtaccompanyingthelearningstyleandbrainprocessingmethodofthestudent.Eachstylehasitsownpreference,andthiswillbeexpressedasthemaptakesshape.Symmetryallowsforeachportionofthemaptobeconsideredseparately.Thiscanassiststudentswithanalyticalreviewandrein-forcelearning.Itmayalsoprovideastartingpointforfacultyinevaluationandgrading.

Figure 5-5incorporatesmorevisualcomponentsandasmootherformat.Double-pointedarrowsindicateaglobalinterrelationshipbetweenallconcepts,asdothedescrip-tivephrases.Itisalsomoreofanaction-basedmap.Takeamomentandconsiderthetypesofdescriptivephrasesusedinbothmaps.Thefirstmaphasastrongerfocusonplanning,whilethisexampleplacesmoreemphasisoncarryingoutactionsrelatedtoseeingthepartythrough.

Inthismap,thereismoreofafocusontherelatedconceptsandhowtheycontributetothemainconcept.Younowbegintoseehowrelationshipanalysisisaccomplishedin


GuestsConsider

Dinner party

Courses anddietary

considerations

Number andinvitations

Menu choices

Depends on

Determines

Supplies

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variedways.Eachofthesemapsisdemonstratingthesamething.Itisonlytheformatthathaschanged.Whilethefirstmap’sstructureappearstobeveryconcreteandtightlystructured,thesecondmap’sislooserandmoreopen.Eachmapshowsastartingpointaswellasthecriticalthinkingandanalysisallowingtheendpointtobereached.Eachdemonstratestheactionneededtoplanandhostasuccessfuldinnerparty.Thisequatesto the stepsofassessing,planning, implementing,andevaluatingweknow fromthenursingprocess.Wehaveassessedtheneedsinvolvedinhavingtheparty.Afterthat,weplannedandimplementedwell-thought-outstrategies.Althoughevaluationisnotclearlydemonstratedintheseexamples,itwouldoccurafterthehostorhostessreflectsonposi-tiveoutcomessuchashappyguestsandpositivecomments.

ThereisalsoamuchstrongervisualfocuswiththemapinFigure5-5.Photosandclipartcanhaveastrongimpactinstimulatingcriticalthinkingforvisuallearners.Visualizingasituationoractioncanprovidevaluableinsightintojudgmentandfollowthrough.Itisimportanttonotethatifthepicturesdonotappearonthemapastudentcreates,theycanbementallydepictedimagesthataidinmapcreationandformatting.

Fornonvisuallearners,simplyseeingtheirmentalactionswrittenonpaperwillaccom-plishthesamething.Inthissituation,however,thatdepictionmaybeinwords,lists,orphrases.Ioftentellstudentswhoarehavingdifficultyvisualizingnursingactionstositquietlyandpicturewhattheydidfortheirpatientstepbystepthroughouttheday.Thentheycanbettercreateamapbasedonthoseactions.Thishelpsallstudents,regardlessoftheirlearningstyles.Thisinsightthenbecomesintegralinevaluatingtheknowledgeapplicationprocess.Afteryoufinishstudyingandcomparingallthemapsshownhere,askyourselfwhichonelooksbesttoyouandwhy.Thencomparethatwithyourlearningstyle.Howdoesitmatchup?

Let’s lookatonemoreexample.Figure 5-6 isbasedmoreonaverbal learningstyle.Itfeaturesatop-downapproach,asimpleformat,lists,andaninterconnectednessofallconceptsbythelinkedboxes.Thefocusisthemainconceptandhowthesmallerconceptsrelatebacktoit.Thisisagreatexampleofthefactthataconceptmapdoesnothavetobeartisticallycreative.Thismapcontainsalltheinformationseenintheothers


My dinner party

Needs

1. Guest list2. Invitations

1. Menu plan2. Special dietary needs3. Food allergies

In consideration of

1. Supplies2. Cost

Plan for

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yetisshort,concise,andtothepoint.Itstilldemonstratesthesamething.PleasedonotmistakethesimplicityanddirectnessofthismapasnothavinginsightasIspokeaboutearlier.Simplicityandstraightforwardnessdoesnotequalshortsightedness.Thesechar-acteristicsreflectadifferentlearningstyleandmentalprocessingandarelikeasnapshotofinformation.Thismap,astheothers,wouldneedtobeexpandedasneededtobecompleteandthorough.

Bothsimplicityandcomplexityinamaparedeterminedbylearningandbrainpro-cessingstyles, topic,subjectmatter,andtheparticular focusofthemap.This is truewhethertheconceptmapisnursingbasedornonnursingbased.

Thereareotherpossibleformattingoptions,personallytailoredbyyouaccordingtoyourlearningstyleandhowyourbrainprocessesinformation.Anessentialpartofdis-coveringformattingoptionsispractice.Allofthethoughtandreasoningprocessesusedincreatingaconceptmaparemethodsyouarealreadyusing,whetherinthenursingskillslaborintheclinicalsetting.Nowyouneedtopracticebytakingyourthoughtsandactionsandtransferringthemtopaper.Obtainingaglimpseofyourthoughtsonpaperisapowerfultoolforself-evaluation.

Allthreeformattingexamplesshownherereinforcesomeimportantpoints:

1. Learningstylesareevidencedincompletedconceptmaps.Thisistruewhetheramixtureisnotedoronecertaintypedominates.

2. Creativeexpressionisevidentandreflectsoncriticalthinkingabilities.Thisreferstohowyouareabletodemonstratetheconnectionbetweenconcepts.

3. Individualformattingstylesarepartiallydeterminedbymentalinformationpro-cessing.Thisstatementisdrawnfromconceptmappingtheory.Whileformattingisinfluencedbylearningstyle,mentalprocessingoflearnedknowledgeisneces-saryinstructuringandformattingaswell.

Evaluation and Review of Your Concept MapOnceyourconceptmaphasbeencompleted,evaluationandreviewareessential.Theprocesswillbecomefasterasyougoandwillplayanimportantroleintheself-reflectionprocess.Achecklistishelpfulincompletingthisprocess.TheexampleinFigure 5-7explainshowusingachecklistcanhelpensurethatyouhaveincludedallnecessaryinfor-mationwithinyourmap.Itisthatfinalstep,suchasyouwouldusepriortosubmittingascholarlypaperorotherassignment,whereyoucheckthefinalproductforcomplete-ness.Inadditiontoservingasareminderofwhattoinclude,thisprocessalsoreinforceslearningthroughrepetitiveanalysisofyourmap’scontent.

Thisparticularchecklist isnota rubricbuta listofconsiderations forevaluationbasedonconceptmappingtheory.Pleasenotethatmoststudentsdonotfullyachieveallofthelistedcomponentsatfirst.Conceptmappingisalearningprocessandneedstobepairedwiththeory,experience,andnurturingofcriticalthinking.Asastudentyouneedtoknowthateachmapshouldbecomemoredetailed,complex,andcompleteasyouproceedthrougheachweekofthesemester.Thisisnotbecauseyoulackeithertheknowledgeorthecriticalthinkingabilitiestoacethisonthefirsttry,butbecauseyouareusingyourthoughtprocessesinadifferentway.Thewayyouthink,process,andlearnhavenotchanged.Whathaschangedmaybethenumberofstepsyouusetotravel

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EvaluationandReviewofYourConceptMap 95

frompointAtopointBandhowyoumayhavetoreorganizethosestepsandthoughtstotransferthemtopaper.Althoughyoumayfeelyouareprocessinginformationtotallydifferently,Icanassureyouthatthisisnotthecase.

Nowitistimetoconsiderallwehavelearnedsofartoconstructamapfromanursingexample.Wewillusearelativelysimpleexample.Moreexampleswillfollowinsubsequentchapters.Considerthefollowingscenario:You are getting your elderly female patient out of bed for the first time following a bowel resection the day before.Aswecompleteeachstep,pleaseusetheprecedingpagestotestyourselftoseeifyourememberhowtoproceed.Theremaybeafewmorestepsthanthenumberlistedearlierbecauseweneedtobreakthingsdownabittothoroughlyaddressallcomponents.

Step 1Ourfirststepistoidentifythemainconsiderationortopicforourmap.Althoughsev-eralthingsstandoutwiththispatient,itistheactofgettingoutofbedthatisourmainfocus.Becausethispatientisapostoperativepatient,ourmain topic,concern,orfocuscanbelabeled:assisting the fresh postoperative patient out of bed.Nowwearereadytoformulatetheproblemlist.

Step 2Oursecondstepistostartalistandthenpopulateit.Wehaveanactivityordertogetthepatientoutofbed.Wealreadyhaveaheading.Nowweneedtothinkaboutalltheotherrelatedconsiderationsthathavesomesortofrelationshiptothisaction.Takeamomenttothinkaboutthis,andthenlookatthelistIhavecreated.Ifyourunoutofideas,usetheminichecklistinFigure 5-8toguideyou.Theminichecklistfeatures

Figure 5-7 Component checklist.

Component Yes No Notes

Ismymainconcept/mapfocusshownclearly?

Arerelatedconceptsdifferentiatedfromthemainconcept?

Domydescriptivephrasesshowinterrelationships?

Doesmymapdemonstrateallconnectionsthatexist?

Isakeynecessarytointerpretthemap?

Isthemaplegible,uniform,andeasytofollow?

Ismymapcomprehensive?

DidIincludeallnecessarycomponents?

DidIfollowallthesteps?

Isthereevidenceofadequateknowledgeandtheabilitytoapplyit?

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maincomponentsyouwouldinclude,basedonconceptmappingtheory.Asstatedear-lier,itmayhelpyoutothinkaboutapatientyouassistedoutofbedinthepast.Whatthingsdidyouthinkaboutbeforeyoucompletedthattask?Whatinformationdidyouhavetoknow?Allofthesethingsbecometherelated conceptlistings.Thisstepisalsowhererelationship analysisshouldappear.Relatedconceptscannotbeconsideredwithoutaknowledgebasethatallowsforcomparisonandrecognitionofconnectionsthatexistbetweenactionsandthefactorsthatmustenterintodecisionmakingbeforeanactioniscarriedout.Inadditiontotheminichecklist,overallgeneralcategoriestoconsiderandthatwillassistyouare:

• Safety• Communication• Theimpactofthehistoryofpresentillness(HPI)andpersonalmedicalhistory

(PMH)• Anydiagnosisorinformationrelatedtopatientambulation

Thischecklistmaybeusedwitheitherstaticorlivingmaps.Itmayneedtoberevisedsomewhatdependinguponthefocusofthemap,particularpatientconsiderations,thecaresetting,andtheactiontobeperformed.Whatmaychangeisthesectiononthoughtprocessesandrationales.Thecomponentswill always remain the same,because theyembodyconceptmappingtheory.Usingthisminichecklist,whichcanbetailoredtoaspecificpatientorsituation,withthecomponentchecklistwillassistyouinformulatingacompleteandthoroughproblemlistandconceptmap.Inamomentwewillusetheminichecklisttoevaluateourproblemlist.Atthispoint,youshouldbeabletodeterminethatconstructingaconceptmaprequiresuseofconceptmappingtheory,useofallnec-essarycomponents,andaknowledgebasefromwhichtodrawinformationforanalysis.Applyingconceptmappingtheoryalsoallowscomparisonandcontrastbetweenoldandnewknowledgeinawaythatreinforcestheapplicationofit.

Figure 5-8 Mini checklist.

Component Thought Processes/Rationales

Criticalthinking Whatparticularfactorsaffectthisactionbasedon:• Patienthistory• Safety• Communication• Relatedfactors

Relationshipanalysis Howdoalloftheseconsiderationsaffecteachotherandenabletheactiontobecompleted?

Application Usealloftheabovethoughtprocessesandrationalestoformulateaplanandcompletethistask.Thisdeterminesspecificactionslistedinyourmapandalsoconsidersoutcomes.

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Problem List

Main Concept:Assistthefreshpostoperativepatientoutofbed.Related Concepts:Considerationsrelativetocompletingthistaskinclude:

• Patienthistoryrelatedtoanymobility/ambulatoryconcerns• Diseases/conditionscausingmobility/ambulatorydysfunction• Sensorydeficits• Pasthistoryoffalls/PMH• Historyofsyncope• Mentalstatusandabilitytounderstandteaching

• Currentconsiderations• Abnormallabtestscontributingtosyncope• Medicationeffectsleadingtodizziness/syncope• Paincontrol• Needforanyassistivedevices/personnel• Incisionalsupport

Let’s takeamoment toanalyze the list. Inconsiderationofcritical thinking,weknowsafetyisofprimaryconcern.Weneedtohaveknowledgeofallfactorsthatmightcontributetoanyadversesafetyoutcomes.Ouractionswithinthemapwilldemonstratethis.Ifwetakeacloserlookatourlisttodetermineinterrelationships,weseethatpatienthistoryandallofitscomponentsdirectlyrelatebacktoourtaskathand.Failuretocon-sideranyoneofthoseitemsmayresultinundesiredoutcomes.Perhapsourpatienthasahistoryofambulatorydysfunction,afactthatgreatlyimpactstheactionofassistingheroutofbed.

Communicationisanessentialpartofthistaskbecauseweneedthepatient’scoopera-tion.Mentalstatusandanysensorydeficitsrelatetoourmaintaskandgoalofgettingthispatientsafelyoutofbed.Thepresenceofanydeficitsmaymeanthetaskwilltakelongerandrequiremoreeducationaswellasmorereinforcementofittoensureunderstanding.Splintingtheincisionwillaidincontrollingsomeofherpainandpreventwounddehis-cence.Thepatient’sabilitytocomprehendandfollowdirectionsisintegraltooutcomes.

Therelatedfactorsunderthecurrentconsiderationshavearelationshipwithcriticalthinkingandrelationshipanalysis,aswellasapplication.Ifwearenotabletorecognize,consider,andresearchthese,thereisacriticalthinkingdeficit.Paincontrolisessentialbeforewebegin,butwemustalsorecognizesideeffectssuchasdizziness.Majorsurgeryusuallymeansbloodlossequivalenttoatleastahalfunitofblood(approximately200mL)orpossiblymore.Knowledgeofhemoglobinandhematocritlevelswouldindicatewhetherthepatientmayexperienceorthostatichypotension,whichincreasesherfallrisk.Finally,allofthistranslatesintoapplication,becausethatistheculminationofalloftheconsiderations,relationships,andactionswehaverecognized.Doesthisallmakesense?Canyourecognizethenursingprocesswithinthisscenario?

Ourthoughtprocessesherehavedemonstratedbothconceptmappingtheoryknowl-edgeandthestepsofthenursingprocess.Wehave identifiedwhereeachcomponentofconceptmappingtheoryentersintoourdecisionmaking.Wehavealsoassessedourpatient’sneeds,diagnosedpatientdeficits, andplannedactions tocompleteour task.

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Implementationwillbetheactoftransferringthepatientfrombedtochair,andevalua-tioncanbeaddedtoourmapsasasectiononhowthispatienttoleratedtheprocedure.AlthoughIhaveemphasizedhow theconceptmap itselfwillhighlightyourcriticalthinkingskills,youcanandshouldeasily see that theprocess startswith the relatedconceptlist.Ifyouareunabletorecognizeeveryessentialconceptthataffectsorhasarelationshipwiththemainconcept,youmayneedtotakeanotherlookathowyoucriti-callythink.Thesameistrueifyoulackinsightintointerrelationshipsbetweenitemsontherelatedconceptslistaswellasthosethatoccurbetweenthatlistandthemainconcept.Makingassociativelearninganactiveprocess—alearningandcomprehensionfocusbasedoninterrelationships—willassistyouinachievinggoalsofenhancedcriticalthinking.

Step 3Inthisstep,wearereadytochooseshapesandbeginformattingourmap.Butbeforewedothis,wehavetodeterminehowwewanttoidentifyandlabeltherelatedconcepts.Forthisexample,therelatedconcepts’shapeswillcontainthenecessarynursingactionsrelativetogettingthepatientoutofbed.Lookingatthelistwehavecreated,itisevidentthatthereareprimaryormainconcernsandsecondaryconcerns.Averyimportantcon-siderationinthisstepisdecidingwhataprimeareaoffocusisandwhatthenextendsoffoforstemsfromthatprimaryconsideration,whichthenbecomesthesecondaryconsid-eration.Thisiswhatwemeanbytakingactionsoutfarenoughonaconceptmap.Thatprocesstakesintoconsiderationallstepsneededtomeetallrequirementsofmappingtheory,allowingforoutcomes.Thisisoneofthestepsinrelationshipanalysis—beingabletocompareandcontrastthroughisolatingandexaminingindividualandgroupedconcepts.Takeafewminutestothinkaboutthisandgiveitatry.Thenlookatthefol-lowingexample.

Onceyouhavedonethat,itistimetochooseshapesforthemainandrelatedcon-cepts.Chooseanyshapesyouwouldlike.Enterthemainconcept.Then,beforeaddingtheconnectinglines,decideontheformattingyouwilluse.Uselargepaperandapencilwithaneraser.Takeyourtimeandexperimentwithformatsyoulike.Rememberthatthoseyoulike,thatappearverypleasingtoyoureye,willbealignedwithyourlearningstyleandmentalprocessingmethods.Draw,erase,andreformatasneededuntilitlooksthewayyouwantit.Onceyouhavecompletedthattask,addlinesandlinkingphrasesforthisfirstsection.(YoucanalsouseaConceptMapCreatorfromtheStudentCompanionWebsiteathttp://go.jblearning.com/schmehl.)

Figure 5-9isanexampleofthefirststepsutilizedincreatingaconceptmapforourpatient.Colordifferentiatesthemainconceptfromourprimaryrelatedconceptsinsidetheheavilylinedboxes.Thesehavebeenidentifiedashavingaprimaryfocusbecausetheywillguideouractions.Thinkbacktothedinnerpartyexample.Althoughwehadanentirelistofconsiderations,weseparatedoutthosethingsthatwerenecessarytofocusonthatwouldthenincludealloftheothers.Thefirstsetsareareasandactionsthathavetobesatisfiedbeforewecanmoveforward.Andsoitisinthisexample.Everythingwebeginwithconsidersfactorsrelatedtosafety,communication,patienthistory,andotherrelatedfactors,asweidentifiedearlier.Eachprimaryrelatedconceptextendsfromthemainconceptasidentifiedbythearrows,andthecyanlinkingphraseboxesexplaintheirrelationshipbacktothemainconcept.Youcaneasilyseethateachlinkingphrasespeakstoanaction.Eachactioncanbeequatedtoastepinthenursingprocess.TheblockscontaininginformationonPMHandcurrentconsiderationswouldbepartofassessment,

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diagnosis,andplanning.Theboxescontaininginformationonpainandincisionalsup-portaretheimplementation.

Step 4Ournextstepistocompletethemapbyaddingthesecondaryrelatedconcepts,alongwiththeirspecificlinkingphrases.Usecolordifferentiationifnecessaryandbesuretoincludeakeyifneeded.Thiswillincludeanyremainingitemsfromourlistnotprevi-ouslyaddressed.Again,theyareournursingactions—thingswewillspecificallyneedtoperformtoensurepositiveoutcomesrelatedtoourgoalofgettingthepatientoutofbed.Sourcesforobtainingsomeofthisinformationmaybe:

• Thepatient’sverbalstatementsorhealthhistory• Thenursingdatabase• Thechartitself• ThepatientKardex• Familymembers• Vitalsigngraphs• Themedicationadministrationrecord(MAR)

Figure 5-9 Example of the first steps utilized in creating a concept map.

Assisting the freshpostop patient out of

bed

Take into account

PMH:

Falls

Syncope

Current considerationsaffecting safety

Ensure/address

Pain control Incisional support

Be aware of

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Ifyouarenotfamiliarwithwheretofindvaluablepatientinformationonthechart,pleasetaketimetoreviewthis.Insomeinstitutionshardcopychartshavebeenreplacedcompletelybyelectroniccharts.Thesemaydisplayinformationinadifferentformatthatmakesitdifficulttofindand/oraccessinformation.Otherinstitutionsmayhavebothtypes.Requestanorientationperiodwhereyouhavetimetoresearchbothtypes.Youcannothavefullknowledgeofyourpatientwithoutthisinformation.

Thehistoryandphysical(H&P)sectionwillcontaintheadmittingdiagnosis,HPI,andPMH,aswellasanypastsurgicalhistory,socialhistory,andmedicationlistings.Psychosocial,cultural,andanysubstanceabusehistorywouldalsobefoundthere,andincludingthisinformationinyourplanisintegraltoprovidingholisticcare.Thenursingdatabasewillhaveahealthhistory, theadmissionphysical assessment, and religiouspreferences.

Step 5Nowthatourmapiscomplete,wehavetoreviewitforclarity,symmetry,allcompo-nentsofconceptmappingtheory,andinformationflow(seeFigure 5-10).Youmayrecallthatyourmapmayhaveadifferentformatting.Aslongasitmeetsallthecriteriawehavebeendiscussing,thatisfine.Notwomapsareorhavetobeexactlyalike.Theexamplemapclearlydifferentiatesbetweenthemainconceptandtherelatedones.Ifwehadmoreroom,wecouldbeevenmorespecific.Let’sexamineeachofthenumberedboxesinFigure5-10andthinkaboutwhatelsewecouldadd:

1. Thisboxaddressesdeficits.Thingstoincludeherewouldbedeficitspresentpost-cerebrovascularaccident(CVA)suchasaflaccidextremity,alimbwithafracture,anamputatedlimb,blindness,aneuromusculardisease,orgeneralizedweakness.Anyoftheseareimportanttooutcomeswhenitcomestotoleranceoftheactivityanditsduration.Includeanyassistanceandthenumberneeded,aswellasanyassistivedevicesused.Aninclusionandawarenessoftheseindicatestrongcriticalthinkingskills.Gettingapatientoutofbedseemssimple,butmanyindividualfactorsmustbeconsidered.

2. Inthissection,otheractionstobeincludedwouldbetheneedfordanglingthepatienttoassess fortolerancewhenthebloodpressure isorthostatic.Identifyspecific lab results suchashemoglobinandhematocrit thatcontribute to theprecedingfacts.Becausethisaffectsoxygenation,includingmeasurementssuchasoxygensaturationandanyrespiratorysymptomsthatoccurwouldbeanexcellentidea.Anymedicationeffectsresultingindizzinesswouldbenoted.Perhapsthemedicationwouldneedtobehelduntilthepatientisreturnedtobed.

3. Painmustbeassessedbeforetryingtomovethepatient.Thingswillproceedmuchmoresmoothlywhenthepatientcantolerateit.Addingaboxforthemedi-cationname,dose,andeffectivenesswouldaddressthis.Inaddition,apainscorebefore,during,andafterwouldindicatepainmedicationeffectiveness.

4. Iwouldincludeteachinginthissection,aswellasreturndemonstration.Alsovaluablewouldbeawoundassessment,bothbeforeandaftertheactivity.

Thelastelementyoucouldaddwouldbeadditionallinesshowingtheinterrelationshipsbetweendatagroupings.Forexample,addingdashed linesconnecting syncopewith

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Figure 5-10 Completed concept map.

Assisting the freshpostop patient out of

bed

Take into account Be aware of

Current considerationsaffecting safety

Have knowledge of

Ensure/address

Research

Pain control Incisional support

Educate regarding

Pain score

Need for medicineprior to activity

Proper splinting ofsurgical site

Use of binder ifordered

Assess

Any deficits necessitatingadditional help or any

assistive devices1 2

3 4

Vital signs—recent andtrends for orthostasis

Lab results for anemia

Medication effects

PMH:

Falls

Syncope

Main concept Key

Primary concept Secondary concept

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medicationsandabnormal labswould showthat syncopehasoccurred secondary tothosefindings.

You shouldnowbegin to see the typeandvolumeof informationneededwhendeterminingnursingactionsaswellastheirsources.Alwaysstrivetoknowasmuchaspossibleaboutyourpatient.Haveadequateknowledgeofavailableresourcesandhowtoquicklyaccessthem.AsIstatedearlier,nothingisstatic.Thisprocessisagreatexampleofthatstatement.Asyouproceed,youareapplyingbutalsocontinuingtolearn.Infact,everythingyoujustdidisapplication.Now,thelastthingistousethechecklistprovidedinFigure5-7toreviewyourmap.

SummaryInsummary,aconceptmapcanbeassimpleorcomplexasyouneedittobe.Simplicityorcomplexityisoftenaffectedbythemap’spurposebutisalsoanindicatorofyourcriticalthinkingskills.Forinstance,inthecreationofaskill-relatedstaticmap,arelativelysimplestylecanbeutilizedbecausetherelationshipsaresimplerandthelistofrelatedconceptsmaybesmaller.Alarger,morecomplexlivingmaprelatedtonursingcare,however,oramoreinvolvedskill,willbemorecomplexbecausetherearemoreconceptstoconsiderandagreaterdegreeofin-depthcriticalthinkingskillsisrequired.A concept map is a direct expression of your critical thinking, problem solving, and clinical judgment skills.

Following specific steps forproblem list andconceptmap formatting, aswell asapplyingconceptmappingtheoryanduseofbasicoradvancedcomponents,allowsyoutoblendpastandpresenttheoryforthemosteffectiveandmeaningfullearning.Thisentireprocessalsoimpactsandisimpactedbythenursingprocess,standardsofcare,andevidence-basedpractice.Conceptmappingisapowerfultoolforblendinganddemon-stratingallofthesepractice-definingnursingstandards.

Wehaveusednonnursingexampleswithin this chapter, aswell asnursingbasedones.Itisawonderfulwaytocompareandcontrastknowledge.Youcancontinuetousethisideaasyougainmoreunderstandingaboutconceptmapsandtheirusewithinnursingeducation.Examplessuchasthesewillallowyoutoenvisionhowconceptsaffecteachotherandhowthoseeffectsrelatetodecisionmaking.Thescenariosyouchoosecanbeverysimpleandinvolvefewactionsandconceptualinterrelationshipsorbeabitmoreexpansive.Theimportantthingisthatyouarethinkingintermsofassociations.Thistypeofpracticealsoreinforceshowyouresearchandextractinformationsources.Implementingtheseconceptswithanonnursingexamplemakesitmucheasiertothensubsequentlyapplyitinnursingpractice.

Wehavealsodiscussedtermssuchassymmetryandclarityinconceptmapformatting.Stylemayvaryamongindividuals,butbeingabletodemonstratekeyconceptsclearlyisamustforeffectivelearning,interpretation,andreflectionpurposes.

Critical Thinking Questions and Activities1. Discussthesimilaritiesanddifferencesinusingnonnursing-andnursing-based

examplestounderstandconceptmappingtheoryandproblemlistformulation.2. Usethefollowingnonnursingexampletoanswerquestionsrelatedtoconcept

mapping:

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CriticalThinkingQuestionsandActivities 103

You are planning to clean out your car and wash it.a. Createaproblemlistidentifyingthemainfocus.b. Identifytheprimaryandsecondarycomponents.c. Createaconceptmapdemonstratingyourthinkingrelatedtothesupplies

neededandtherationaleforchoosingthem.3. Createaproblemlistandconceptmapdetailingnursingactionsforapatientwith

alargevolumeIVinfusion.Inaddition:a. Discussyourrationalesfortheprimaryandsecondaryconceptsyouidentified.b. Compareyourconceptmapandproblemlistwithyourclassmates’mapsand

lists.4. Discussboththedifferencesandsimilaritiesbetweennonnursing-andnursing-

basedconceptmapsinrelationtotheproblemlistandconstruction.5. Discussyourthoughtprocesswhencompletingthefollowing:

a. Identifyingproblemsfortheproblemlistb. Thinkingaboutconceptmapconstructionc. Howyoumakeassociations,connections,andlinks

6. Discussandshareideasforotherwaystothinkaboutthetermproblem list.Whatadditionaltermsmightbeapplicabledependentuponthespecificpatientcaresituation?

Case StudiesDirections:Readthrougheachcasestudyandanswerthequestionsusingthechaptermaterialprovided.

1. Katiehasbeenaskedtocreateaconceptmapfocusedonasimplenonnursingexampletohelpherandherclassmatestounderstandconceptmapconstruction.Shedecidesonstepstoconsiderwhenbuyinganewcar.a. HowshouldKatiebegintocreatethisconceptmap?b. Whattypesofthingswillmakeuptheproblemlist?c. Whatcriteriaareusedtodifferentiatebetweenmainandrelatedproblems/

concerns?2. Katiehasconstructedherconceptmaplikeawheelwithspokes.Shehasplaced

thephrase,“buyinganewcar,”inthecenterandallrelatedconceptsspreadingoutfromthat.HowdoesthiscorrelatewithKatie’s learningandmentalpro-cessingstyle?

3. Toddiscreatingaconceptmapforoneofhispatient’smainproblems:surgicalwoundcare.He ishavingdifficultydemonstrating informationflowandrea-soningrelatedtotheactionshehascarriedout.Hisgoalistoshowhisnursingactionsinresponsetowoundassessment,redressing,andcaremanagement.a. Howdoesconceptmapconstructionrelatetothis?b. Howdodesignandtheuseofdescriptivephraseshelpwiththeflowofinfor-

mationanddecisionmaking?

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c. Howcanbothdesignandconstructionreflectcriticalthinking?d. WhataresomeothertoolsandtechniquesToddcouldusetohelpexplainhis

conceptmapandmakeiteasiertofollowandinterpret?4. Lucyhasaskedhowtheuseofcolorcanbestbeusedtoemphasizeorhighlight

afeatureofherconceptmap.a. Whatisthebestanswertothisquestion?b. HelpLucytounderstandthisthroughprovidingherwithsomebasicrules

forusingcolorwithinaconceptmap.c. Howcancolorandsymmetrybeusedtomakeaconceptmap’spurposeclear?d. Howdoestheuseoflinetypesaffectinterpretation?

Forafullsuiteofassignmentsandadditionallearningactivities,usetheaccesscodelocatedinthefrontofyourbooktovisitthisexclusive

website:http://go.jblearning.com/schmehl.Ifyoudonothaveanaccesscode,youcanobtainoneatthesite.

ReferencesAltmiller,G.(2010).Qualityandsafetyeducationfornurses:Anintroductiontothecompetenciesandthe

knowledge,skillsandattitudes.Retrievedfromhttp://www.qsen.org/teachingstrategy.php?id=148.Conceição,I.C.O.,&Taylor,L.D.(2007).Usingaconstructivistapproachwithonlineconceptmaps:

Relationshipbetweentheoryandnursingeducation.The National League for Nurses Journal, 28(5),268–275.

Hsu,L.,Hsieh,S.-I.(2005).Conceptmapsasanassessmenttoolinanursingcourse.Journal of Profes-sional Nursing, 21(3),141–149.

Struth,D.(2009).The60secondsituationalassessment.Retrievedfromhttp://www.qsen.org/teachingstrategy.php?id=89

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