Teaching planning and reflection in nurse education

Abstract

In many Western countries the growing need for cost-effective health care requires changes in the roles of nurses. There is an increasing need for nurses who are capable of working autonomously in delivering patient care. In their professional work, nurses increasingly need social skills to cope with time restrictions and critical reflective attitudes to judge the appropriate course of their actions. Health-care institutes also expect nurses to be prepared for life-long learning. The changing demands on nurses put nursing schools under pressure to reconsider their curricula. A central aspect is the need for integration of theory and practice. The introduction of problem-based learning (PBL) (Biley & Smith 1998) could be helpful in this regard. In PBL, students at the nursing school are offered practical problems that stimulate the learning of knowledge from many disciplines. Students are encouraged to acquire, analyze and carry out appropriate investigations to solve the problems. Criticism of PBL is that it is based on medical training with no eye for the social and normative aspects of nursing practice. Presently, nursing is no longer limited to hospitals. It also takes place in institutes for the elderly or other institutes and private homes. Curricula and teaching, should take into account the different environments for nursing. In this paper an alternative curriculum approach for nurse education is presented that integrates PBL with social skills training and reflection on learning. A number of prominent nurse educators have embraced Schon’s concept of ‘reflection on action’ (Schon 1983). The concept of reflection on action is not restricted to the technical performance of care giving only (e.g. Greenwood 1998). Taking Schon’s ideas to nursing practice,