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Demonstration method

1.Introduction

All instructions should be carefully graded and arranged in a natural


order. The teacher in her method should appeal through sense perception to the
understanding of the learner.teaching in nursing encompasses both cognitive and
artistic aspects. As nursing is field of science and art , the demonstration method is
of utmost importance in the teaching of nursing.

2.Definition

Demonstration can be defined as “visualised explanation of facts, concepts and


procedures”.

.Demonstration refers to an “explanation of a process by exhibition”

As per oxford, demonstration is a practical . exhibition or”explanation of


something , designed to teach or inform. Or

Demonstration is the process of describtion and explanation of scientific


propositions by experiment ,practical use etc.

Demonstration as a teaching strategy refers to the visual presentation of the action


and activities or practical work, related to the facts and principles of a delivered
lesson aiming to facilitate the task of teaching and learning.

3.Meaning of demonstration

The demonstration method has universal appeal because it is


understandable to all. It teaches by exhibition and explanation. It commands
interest by use of concrete illustrations. The student not only can hear the
explanation,but also can see the procedure or process. As a result demonstration
method projects a mental image in the students mind ,which fortifies verbal
knowledge.

4.The purpose of demonstration:

a.Those designed to show the learner 'how' to perform certain psychomotor skill.

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Here the learner must reproduce exactly the behavior of demonstration.

b. Those designed to show the learner 'why' certain things occur. Here the
behavior is intended only as a strategy to aid the learner's understanding of a
concept of principle.

A demonstration is useful either by itself or to accompany a formal lecture or


informal talk in the classroom, laboratory or clinical area.

In respect of a procedure in which the student needs to gain a degree or skill, she
should be asked to make a return demonstration which should be followed by
opportunities for practice.

Demonstration by teacher alone should be carried only where the procedure is


not one that the student has to master or when the time which it would take for the
return demonstration is out of proportion to its value.

Thus it is one of the important methods to teach nursing. In nursing, it is used for the
purpose and also for clinics, conferences, laboratory classes, symposium, autopsies
and teaching or health to patients obviously, this method is of utmost importance in
teaching of nursing.

5. Uses of Demonstrtion Method:

The important uses of demonstration method are:

1. To demonstrate experiments and the use of experimental equipment in the


science laboratory, Medical, Nursing, etc.
2. To demonstrate procedure in the classroom and the ward to review or revise
procedure to meet a special situation or to introduce a new procedure.
3. To teach the patient/client a procedure to treatment which he must carry out in
the home.
4. To demonstrate a procedure at the bedside or in the ward conference room,
demonstration of a procedure in natural setting has more meaning.
5. To demonstrate different approaches in establishing support with client, the more
effective nurse-patient relationship may be established.

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6.Characteristics of Demonstration

• The demonstrator should understand the entire procedure before attempting to


perform.
• All equipments needed should be assembled and pretested before demonstration.
• Knowledge (theoretical aspects) above the procedure should be given to the
students before starting procedure/demonstration.
• A positive approach should be used, emphasis should be placed on what to do ,
rather than what not to do.
• Everybody should have a good view of the demonstration, precautions should be
taken to ensure allround comfort.
• The person incharge of the demonstration should accompany it with running
comments relative to materials used, amounts necessary, process taking place,
and anticipated results.
• The setting for the demonstration should be as true to life as
possible.demonstration of anusing procedure should be done on a live model
wherever possible.
• A discussion period should always follow the demons-tration.this affords an
opportunity for reemphasis,recall, questioning, evaluation and summary.
• The students should be provided with opportunities for prompt practice of the
procedure (demonstration).
• Lecture –demonstration : is a combination of the lecture and demonstration. Its
purpose is to point out relationship as they occur during a demonstration.
• The television Lecture –demonstration: this method used most frequently in t.v
teaching.

7.Advantages

1. It activates several senses: Teaches by exhibition any explanation. This


increases learning because the more senses used, the opportunities for
learning. It trains student in the art of careful observation a quality which is so
essential to good nurse. It is method in itself learning through observation and it
uses several of the senses.

2. It provides opportunity for observational learning. The student not only hear the
explanation, but also can see the procedure or process. It projects a mental

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image in the student mind, which fortifies verbal knowledge.

3. It clarifies the underlying principle by demonstrating the 'why' of the procedure.

4. It commands interest by use of concrete illustrations.

5. It correlates theory with practice.

6. It gives the teacher an opportunity to evaluate the student's knowledge of


procedure and to determining reteaching is necessary.

7. It points out that students must have knowledge and must be able to apply it
immediately-serves as strong motivation.
8. Return demonstration by the student under supervision of the teacher provides
an opportunity for well directed practice before the student must use the
procedure on the ward.

8.Steps to demonstrate a psychomotor skill


A. Before demonstration:
1. Formulate behavioral objectives.
2. Perform a skills analysis and determine the sequence.
3. Assess entry behaviors of learners, and determine prerequisites.

4.Formulate the lesson plan, with particular reference to:


a. ensuring optimum visibility
b. preparation for all materials
B.During the demonstration:
5.State the objectives to the learner.
6.Motivate them by explaining why the skill is important.
7.Demonstrate the total skill at normal speed.
8.Write the sequence of part skills onthe chalkboard, as a checklist for the step-by-
step demonstration.
9.Demonstrate each part skill slowly, in the correct sequence.
10.Obtain feedback by questioning and observation of nonverbal behavior.
11.Avoid the use of negative examples and variations in technique.

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C.After the demonstration:
12.Provide immediate supervised practice, with adequate time allowance.
13.Provide verbal, rather than physical guidance.
14.Make the environment psychologically safe by providing a friendly atmosphere
and constructive criticism.
15.Remember that initial interest may wane so provide motivation and
encouragement.
16.Remember that learners will acquire that skill at different rates, so individualize
the planning to cater for the fast and slow learner.
17.Replace the both.
18.Discuss.

9.Demonstration Method in Nursing Education


In clinical nursing the demonstration method can be both indirect and direct. Of the
indirect routes, the most obvious are those of nursing acts performed by learned
members of the health team and witnessed by students during the normal daily
assignments. It therefore, behaves educators to seek those clinical settings offering
reasonable opportunities for finding health team members who can and do serve as
favorable role models for students to follow.
A more direct version of the demonstration method is a carefully prepared,
expertly presented replication of how to perform a given task. Through the
simultaneous use of several senses it seeks to show how the underlying principles
apply to the given process. When the objective is to present information in a
lifelike situation or to illustrate relationships between theory and practice, a return
demonstration may not be required. If the goal of the demonstration is to assist
students to develop greater skills, the demonstration must include opportunities for
supervised practice of desired skills followed by return demonstrations.
Within the clinical nursing setting the demonstration method provides a
natural and readily adaptable means of teaching, particularly in combination
with the laboratory method. Most commonly with the laboratory method. Most
commonly it is used
i. to teach new procedures either at the bedside or in the ward-teaching
center,
ii. to illustrate modifications of basic procedures to meet the immediate nursing
situation
iii. to make application of the knowledge of underlying scientific principles to nursing
care situations
iv. to teach the use and care of new equipment
v. to teach application of observation techniques and skills to nursing situations,

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vi. to teach ways of establishing effective nurse-patient communications and
interpersonal relationships, and
vii. to teach health maintenance and preventive health care measures to patients
and families.
A variation of the demonstration method is described as Nursing Rounds. This
method utilizes the patient's bed-side as a "live" teaching field for single
concept demonstrations of a variety of nursing care situations. The central
purpose is to provide direct, purposeful experiences aimed improving selected
clinical nursing abilities. Therefore, selection of concepts for demonstration is
usually made from particular nursing care situations encountered in the clinical
setting. This method can be used to advantage in selected situations involving a
limited number of students. While the demonstration has classically been used in
nursing to teach psychomotor techniques such as catheterization, it is valid for
teaching other skills such as the patient interview to obtain health history.
Traditional use of the demonstration method to teach procedures has
perpetrated such practices as
i. Requiring repetitive practice of a given procedure until it can be repeated
correctly step by step by the student, regardless of how well it is understood
and
ii. Requiring every student to practice a given procedure for a designated
number of times prior to being considered "safe" to administer it to patients
without supervision. Students need opportunities to exercise and develop
their intellectual abilities in the direction of curiosity, resourcefulness,
inventiveness, and discovery while learning the various skills needed for the
practice of nursing.
Opportunities for productive thinking add new dimensions to the learning of skills
by bringing out each student's potential ability to view the activities in a new light,
to create something new, and to be ready for new ideas developed by others.
Although, it must be recognized that the development of mechanical nursing skills
requires a disciplined kind of teaching-learning situation, the key to the
development of such skills lies in one's ability to practice safe nursing care with a
minimum of time and effort expenditure on the part of the nurse and the patient
through the economic utilization of available equipment. Herein lie the
opportunities for creative teaching-learning experiences. The following suggestions
are meant as stimulants to the consideration of ways of fostering creativity in the
use of the demonstration method to teach skills for nursing.
1. Prior to the demonstration of specific procedures the clinical teacher should
provide an orientation period to demonstrate those activities basic to all
procedures, such as securing and organizing equipment, preparation of the
patient, modifications for meeting patient's needs, teaching opportunities,
aftercare of the patient, after-care of equipment, and record keeping. Once these
activities are conceptualized as the scientific basis for the practice of all
procedures, it becomes the student's responsibility to practice them as an
integral part of each procedure. Responsibility is centered in the student, with the
teacher acting as the catalyst by providing a wide range of freedom along with

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thought-provoking questions.
2. In presenting the demonstration the clinical teacher should eliminate detailed
steps that seems so obvious as to insult the intelligence of the student. In
demonstrating a procedural technique such terms as place, carry, pick up,
unwrap might well be'eliminated with the assumption that anyone would
automatically make those movements in order to proceed with the task.
3. The clinical teacher should use scientific principles to explain the key steps of
the demonstrated skill. This is a basic ingredient for fostering creativity when
students are given the freedom to perform later in terms of their own perceptions
based on defensible scientific principles. J
4. Creativity in the use of the demonstration method is dependent on the teacher's
effective use of self in the art of inquiry. Vesting the student with the
responsibility for learning charges the teacher with the responsibility for
determining student progress
5. through inquiry. The teacher must be prepared to raise thought-provoking
questions and be equally prepared to allow sufficient opportunity for students to
explore the questions and conceptualize answers. For example, the performance
of procedures in accordance with the student's self-perceived ideas can be tested
by the teacher who asks questions that identify the basic scientific principles the
student used in the performance. This contributes to creative learning
6. a. When.it is used to help students think and to move them from one simple
thought to a variety of thoughts, and
7. b. When students feel that their thoughts, questions, and comments will be
considered and used for growth rather than criticized. Free discussion periods
are of value in helping students conceptualize application of the activity to meet
the needs of the patient. There need not always be a right or wrong answer—the
concepts considered in discussions may be of more lasting value in the transfer
of learning than any pat answer that the teacher could supply.
8. Another dimension of the "art of inquiry" relates to the teacher's ability to allow
students to question. Teachers who are comfortable enough to allow students to ask
and pursue questions, regardless of whether or not they can be answered at the
time, do more towards fostering creative ideas for the present and the future than
those who stifle questions or those who have readymade answers for all questions.
Time pressures on the curriculum, become the scapegoat for teachers who prefer to
give information to be received, stored, and hopefully used at some point in time.
Creativity is fostered by those who allow time to be spent in exploring ideas and
raising questions and issues.
9. . Students need the opportunity to perfect their skills at their own rate of learning.
Mastery of a given skill loses its creativity when it is measured in terms of speed of
accomplishment rather than in terms of quality. Within a reasonable time period all
students need to know that they have an opportunity to achieve; the difference in
the rate of learning lies in the variation of breadth and depth each student acquires.
Students should be thoroughly acquainted with the established criteria for
achievement in a situation. Provisions should then be made for students to work at

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their own rate and be kept informed of their progress.
10. disadvantages.:
 The number of the student is limited.
 Keeps the student in a passive situation.
 High cost in time and personnel.
 Doesnot allow for individual paces of learning.
 Difficulty in repeating demonstration in order to aquire competence.

Conclusion:
Demonstration provides opportunities for productive thinking add new
dimensions to the learning of skills by bringing out each student's potential
ability to view the activities in a new light, to create something new, and to be
ready for new ideas developed by others. Although, it must be recognized
that the development of mechanical nursing skills requires a disciplined kind
of teaching-learning situation, the key to the development of such skills lies
in one's ability to practice safe nursing care with a minimum of time and
effort expenditure on the part of the nurse and the patient through the
economic utilization of available equipment.
Problem-based learning

Introduction:
Memorization is a common occurrence in traditional programmes.
Problem based learning attempts to break this focus by engaging students in
structuring solutions to ral life, relevant problems. Problem based Learning follows
the research of Barrows and Tamblyn (1980) and was first implemented in medical
education in McMaster University in Canada in the 60’s. The rationale for this
strategy centred on the argument that, based on their research on clinical reasoning,
it was more effective to teach medical students through them solving problems than
through the established traditional methods of medical education.
Definition and meaning:

Barrows defines it as: The learning that results from the process of working
towards the understanding of a resolution of a problem.
The problem is encountered first in the learning process.That does not mean that
there cannot be other curriculum inputs e.g. lectures, labs etc, rather, the students
are presented with the problem or trigger first and other curriculum inputs follow
later and may take a different format than traditionally in order to complement/
enhance the work on the problems in the PBL tutorials.
Problem-based Learning is part of the shift from the teaching process to the learning
process. The focus is on what students are learning rather than what the teacher is
teaching.
The “essential features of Problem-based Learning”: The initiating trigger, the
learning that students undertake by researching the learning issues identified in the

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first tutorial, and the use of knowledge in furthering their understanding of the trigger
situation particularly in the final tutorial.
The following definition is also pertinent as it highlights PBL as a way of replicating
problemsolving processes used at work and in life generally:
PBL is both a curriculum and a process. The curriculum consists of carefully
selected and designed problems that demand from the learner acquisition of critical
knowledge, problem-solving proficiency, self-directed learning strategies and team
participation skills. The process replicates the common used systemic approach to
resolving problems or meeting challenges that are encountered in life and career.
Purposes
1. To gain an understanding of principles that underline phenomenon.
2. Helps to aim at problem analyzing skills training in particular professional
situation.
3. To exercise that students learn to take decision independently.
4. Helps to activate prior knowledge and to integrate that knowledge.

Characteristics
There are 4 characteristics common to problem based learning
1. The structuring of learning within the clinical context.
2. The development of an effective clinical reasoning process.
3. The development of effective self directed learning skills.
1. Increase in motivation for learning.

Principles
1. Understanding comes from our interaction with the environment.
2. Cognitive conflict stimulates learning.
2. Knowledge evolves through social negotiation and evaluation of the viability
of individual understanding.
Members
1. The group leader
2. The scribe
3. The group members
4. Tutor
Role of the members
A, Role of the group leader

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• Keeping discussion goal oriented
• Guiding the PBL steps
• Clarifying discussion
• Stimulating participation
• Guiding documentation
• Argument mediator
• Motivator
«Equal participation
• Complete record
• Time gate keeper

B. Role of the scribe


• Records points
• Helps group to order their thoughts
• Participates in discussion.
• Records resources used by the group
• Making clean and short notes
• Summarising information
• External memory
• Not to be selective

C.Role of the tutor


• Encourages group members to participate
• Assisl chair with group dynamics and keeping to time
• Plays a key role in PBL
• Is the back bone of PBL
• Makes learning student centered
• Facilitaics learning instead of dispensing knowledge
• Guides never directs

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• Committed to the groups learning
• Active listening
• Must keep the process alive and on the track by non directive stimuli.
• Should be able to handle small group dynamics
• To allow the group to take over, manage and encourage students to attain a deeper
level of understanding.
• Ability to assess students' ability and problem.
• To ensure all students are involved.
D. Role of chair
• Heads the group through the process
• Encourages all group members to participate
• Maintains group dynamics
• Ensures group keeps to task in hand
• Ensure scribe can keep up and is making an accurate record
E. Role of the group members
• Follow ihe steps of the process in sequences
• Participates in discussion
• Listens to and respect contributions of others
• Shares information with others
• Asks open questions
• Research all the learning objectives I
• Active participation
• Answering questions
• Make decisions
The tutor will - play a facilitative role indirectly guide students learning instead of
giving' students the information, help to keep track of discussion, help students
uncover what they know and do not know, and guide to the resources.
The tutor will not - teach, act as an expert or determine for students which issue to
be discussed.

Steps
Problem based learning consists of 2 sessions.

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Session I: The group selects a group leader and \ a scribe. Both group leader and
the scribe rotate among members during the study block. This session is known as
the brain storming session, i The group leader co-ordinates the session I activities.
The session has seven jumps.
7 steps of problem based learning
The pattern of PBL is a variation of the "seven-step" technique,
1. Clarity
2. Defining
3. Analyzing
4. Shift and sort
5. identify learning objectives
6. Go and learn
7. Come back and talk
1. Clarity: Read the scenario and make sure everyone understands all of the words
that are used in it. Normally, this is fairly quick process.
2. Defining: This is the establishment of what
the problem is all about. There is usually a very strong clue in the study guide!
3.Analyze: Discuss the case together as a group. Work out what you really know
about the various components of the case and try to see how concepts link together.
This is where a "spider diagram" or "concept map" drawn on the flip chart or white
board helps. Challenge yourself and the other in the group to explain how things
work and why do you think what you think. Remember, don't be afraid to say
something "naive" as the PBL group is a safe environment in which you all leam
from each other.
4. Shift and sort: After analysis of the scenario, a group will have a lot of
information on the board with links and other concepts. Decide which you as a
group feel you need to focus on. Remember that you should address each of the
course four themes in every case.
5. Identify learning objectives: Talking through the concepts will allow the group to
identify a number of things that you all need to find out about. Remembering that
there are only four or five days between tutorials is important because the learning
objectives must be manageable by being stated as concise and precise questions.
Avoid general years like 'what is the brain'?
6. Go and learn: Every body in the group goes away to research all of the
learning objectives by using all of the resources at your disposal. Try to
understand what are your reading. This takes time and it is hard work. At first
everyone finds it difficult to work out how much depth to go into. Talk to your fellow
group members and to your friends on the course. Whatever you learn should be

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put into the context of the case you are studying.
7. Come back and talk: You must do this without reading your notes. It is quite
a difficult skill to acquire but ii is the best way to find out if you really understand
what you have been reading. If you are confused or make a mistake someone else
in the group will help-just as we expect you to help them when they are stuck.
Before the second session pursue learning resource pursue learning objectives
individually or together: Utilize text books, journals resource persons, a-v materials
as indicated.
Session II (presentation)
Regroup, synthesize new information and agree on whether item identified and can
be explained to the satisfaction of all members. If not, return to 5, review what has
been learned during study of the problem.
Begin new problem when group is satisfied with solutions for previous problem.
Evaluation
Students will be evaluated on the basis of their performance and placed in one of the
following categories.
E – Excellent
D- distinction
H- honors
P-pass
F-fail
A-absent

Advantages of problem based learning.


A. Increase self direction: It increases self direction in learning and assume increased
responsibility for their own learning by using journals, online searches and library
sources. These processes and learning skills helps students become more competent
in information seeking skills than traditional students.
B. Higher comprehension and better skill development: problem based learning
provides more meaning, applicability and relevancy to classroom materials, When
problems are engaging, difficult and useful, higher levels of comprehension and skill
development occur than in traditional instruction (Albanese & Mitchell, 1993). Real
-world contexts and consequences not only allow learning to become more profound
and durable, but increases the transferability of skills and knowledge from the
classroom to work (Gallagher, Stepien & Rosenthal, 1992). This transferability is
increased because students are able to practice the knowledge and skills in a
functional context, allowing students to better imagine what it will be like using the
knowledge and skills on the job.
C. Interpersonal skills and team work: Few people in the society work in isolation.

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Social interaction is such an important aspect of work life, problem based learning
incorporates collaborative teams in solving the relevant problems. This methodology
promotes the students' interaction and team work, thereby enhancing students'
interpersonal skills such as working with the group dynamic, peer evaluation, and hoe to
present and defend their plans.
D.Self motivated attitude: Researchers have found that students generally favor
problem based learning classes and therefore demonstrate increased attendance and
attitudes than traditional classes (Vemon & Blake, 1993). Students think that problem
based learning is more interesting, stimulating and enjoyable learning method, and
that it offers a more flexible and nurturing way to learn. They feel they are less
threatened by their environment and able to pursue learning independently. This attitude
helps the students to become more self motivated and independent learners
E.Facilitator -student relationship: The aspect faculty liked most is the tutor student
relationship (Vernon & Blake, 1993). The other aspects faculty deem important is an
increase in student motivation, group atmosphere, and student directed learning and
student problem solving. Therefore faculty also considers problem based learning a
more nurturing and enjoyable curriculum and believe the student contact is beneficial to
the cognitive growth of the student.
F.Level of learning: Evaluation done in medical field students learnt through
problem based learning mastered the content than those traditionally leant. Why here is
an increase in learning is being linked by three conditions which improve their
comprehension. They are:
• Are better at activating prior knowledge,
• Learn in a context resembling their future context.
• Elaborate more fully on the information presented.
G.Others:
• Help the student to adapt to rapid changes in information occurring in the world.
• The students, while learning, develop critical thinking and reasoning capabilities.
• It fosters concretively in learning
• It facilitates team work
• Students will feel free lo express ideas
• Special
benefit to students of health profession as they learn to interact in ways which
they may not have encountered previously in the course of clinical practice.
• Helps students to develop analytical thoughts and intrepet knowledge.
• Increase students clinical skills.
• It bridges the gap between theory and practice.
• Helps to maintain up to date clinical knowledge.

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• PBL is an effective means for maintaining clinical reasoning.

Limitations:
 Designing a good problem is difficult and require time.
 Valid assessment of the problem may not be always available.
 PBL sessions are time consuming.
 It is impossible to cover all syllabus by means of PBL.
 Changing role of the student that is previously students were accustomed with
traditional method of teaching and sudden change to PBL leads the students
express difficulty with self directed learning.

Conclusion.
Problem based learning is an innovative method which facilitates effective
learning expensive for the participants. It ensures active participation of
learners. Also helps the learner to acquire first hand knowledge and skills. It is
useful for the students in clinical practice.

Journal Abstract

Problem-based learning for professionalism and scientific integrity


training of biomedical graduate students: process evaluation.
1. Nancy L Jones ,
2. Ann M Peiffer,
3. Ann Lambros,
4. J Charles Eldridge
Objective We conducted a process evaluation to (a) assess the effectiveness of a
new problem-based learning curriculum designed to teach professionalism and
scientific integrity to biomedical graduate students and (b) modify the course to
enhance its relevance and effectiveness. The content presented realistic cases and
issues in the practice of science, to promote skill development and to acculturate
students to professional norms of science.

Method:used open-ended questions, and interviews of students and facilitators to


assess curricular effectiveness.

Results Both facilitators and students perceived course objectives were achieved.
For example, respondents preferred active learning over lectures; both faculty and
students perceived that the curriculum increased their understanding of norms, role
obligations and responsibilities of professional scientists. They also reported an

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increased ability to identify ethical situations and felt that they had developed skills in
moral reasoning and effective group work.

Conclusions These data helped to improve course implementation and instructional


material. For example, to correct a negative perception that this was an ‘ethics’
course, we redesigned case debriefing activities to reinforce learning objectives and
important skills. We refined cases to be more engaging and relevant for students,
and gave facilitators more specific training and resources for each case. The
problem-based learning small group strategy can stimulate an environment whereby
participants are more aware of ethical implications of science, and increase their
socialisation and open communication about professional behaviour.

Bibliography:
1.Aggarwal J.C(2004)”principles, methods and techniques of teaching”.second
edition. vikas publishers.Newdelhi .Page no.233-245.
2.Basavanthappa B.T (2009)”Textbook of nursing education”.second edition. Jaypee
publishers.Newdelhi .Page no.492-499.
3.. Elsa sanatombi Devi.(2006).”Manipal Manual of Nursing Education”. First edition.
CBS publishers.Noida.Page no.181-186.
4.Madhavan nair .s (2006)”Education, its philosophy,psychology and technology”.
Eighth edition. Breeze publishers.Noida.Page no.277.
5. Neeraja K.P. (2003)”Textbook of nursing education”. ”. First edition. Jaypee
publishers.Noida.Page no.252-254.
Journals:
Journal of Medical Ethics 2010;36:620-626 doi:10.1136/jme.2009.035238
Net reference:
1. http://jme.bmj.com/content/36/10/620.abstract
2. http://nursingplanet.com/nr/blog6.php/2009/11/20/problem-based-learning-pbl
3. http://en.wikipedia.org/wiki/Problem-based_learning#Constructivism_and_PBL

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