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1.Introduction
2.Definition
3.Meaning 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.
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.
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.
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6.Characteristics of Demonstration
7.Advantages
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.
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.
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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.
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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
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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
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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
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.
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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