Facilitating Learning in Professional Practice - Essay Example

Facilitating Learning in Professional Practice Health promotion is an internal conception about promotion of health by professionals. The of 'Investigating student nurses' constructions of health promotion in nursing education, Health Education Research' cite White (1994) in their article and opine that it was a conception that explains a system. When a conception is defined it needs deep appreciation of meaning, which makes one enable to apply it practically in new circumstances. The knowledge, conception, understanding is acquired and it facilitates in professional practice. This is the core of the present paper. The word construction can be used in terming the learning of nursing students in course of their education. 1 The conceptions of students change during education and they are studied by vosniadou (1994), Tynjala (1999). Their study gave knowledge about how the student nurses define the health promotion concept's relationship with health education. The student's descriptions about promotion of health emphasised the approaches, which concentrate on life style and changes in behaviour. Some students did not understand the relationship between health promotion and health education and the relationship between them in professional practice. The student must be aware of the interpretations of health promotion and the methods to apply them in practice. The change in conceptions and constructions of student nurses can be viewed as change in conceptions in the learning process. In this course the students understand what is the right meaning of health promotion. When the understanding is advanced the students act like experts. They observe a large area of results due to promotion of health and they will be able to apply them in new and critical situations. When the constructivist idea about knowledge is present, then the learning can be consistent. The learners build their knowledge by re constructing their concepts about health promotion and they interpret new information by using existing knowledge. In the process of moving from education while understanding health promotion to assess competence, it is necessary to be aware of the developments in the student in the course of education.1 In number of countries the teaching regarding health promotion in nursing education is on the basis of two WHO declarations; the Ottawa charter (1986), Health for all 2000. According to those charters, health promotion is defined as a process of making people capable of having control over their health and even to improve it. It should combine the structural change along with individual education. In nursing it is viewed as an integral part of daily practice. It should incorporate disease centred approach as proposed by Robinson and Hill (1995) as they are cited in 'Investigating student nurses' constructions of health promotion in nursing education, health education research'. But this is not enough. For modern needs of the society the nursing students must be equipped with promotion of health, which incorporates societal, political, economic and media aspects. The new approach should refer to interaction about promotion of health, which needs to clarify about the values, beliefs and determinants of health along with behaviour. The aim should be well being of individuals and empowerment of their communities. The promotion of health is situation specific and occurs in even complex situations. Then the knowledge building needs flexibility along with critical thinking, which reflects health promotion. The most complex form of change in student's conception is about revision at the level of theory, which is capable of causing misconceptions. This results in inconsistency and inertia. The studies of Tynjala (1999) establish that the change in concepts occurs on four levels; individual's semantic level, at the level of relationships between concepts, ontological level, and at the level of theory. According to Boud and Walker (1998) the context is the most important influence on reflection of learning. Different types of clinical settings and circumstances will create a major part of health promotion in learning context. The training in education gives a chance to learn from experience. This give rise to reflection, which helps in clarifying and integrate the concept of promotion of health in practical circumstances. Reflection of education in practice and critical thinking can be regarded as crucial elements of effective promotion of health. To connect experience and theoretical concepts by reflection the nursing students must practice and learn these in a clinical setting. In that setting they must be in contact with patients and their problems. The challenge of nursing education is to broaden the role of nursed from a traditional approach. The broadened approach must include the approach of empowerment. Research Method The study aims at investigating the changes about promotion of health in student nurses. The concepts of the students before and after 1 year of education were considered. In Finland promotion of health, taking care, rehabilitation in nursing for different age groups was a part of professional studies were taken as content of curriculum in one polytechnic and emphasis of student's ability to learn to promote and maintain health and to prevent diseases in nursing as the aims in other polytechnic. In the beginning the students described health promotion by manifestation. It was done through four sub categories: 1. health promoting services 2. Healthy lifestyle 3. Health awareness and empowerment and relationships. The aims of promotion of health were seemed as well being or feeling good and the prevention. Out of the 19 students six students stated that their conceptions were not changed but remaining 13 students observed the changes in their conceptions. They expressed their views that in the beginning their views of health were not more than just physical. But after one year of study they recognised other elements of health promotion. They recognised the emotional, social levels of promotion of health. Interaction was termed as most likely reflected element in promotion of health. The vivid examples of sick people taught them he value of health and helped to strengthen the will to learn and help sick people. Participation, facilitation, negotiation and empowerment were the new concepts that students used for explaining the practice. Students acted as experts and dominated the situation. The balance in interaction was not functional in health education. Empowerment approach in health promotion finds its roots in Freire's (1972) critical pedagogy that places emphasis on problem posing and interaction designed to promote reflection critically.1 The model developed by John (1994) is used to help practitioners to view themselves in the context of promotion of health and to develop the required skills. It consists of ; describing the situation, reflection of achievement or target, factors that influence the process, learning. The main problem is integration of practice with theory. The study should provide information about usage of knowledge and skills in practising the promotion of health. The critical points are; importance development in concept, integration of theory and practice and to specify the promotion of health clearly. After studying the activities of nurses in Finland polytechnics five factors that affect the knowledge that influence students' promotion of health interaction were identified. 1. previous experience, 2. knowledge gained during education 3. knowledge gained due to practice. 4. client 5. critical thinking. The experiences of the students formed the basis of the role of student nurse. The objectives of learning, the rules regarding health promotion and the reflection were considered as important in promoting the health. The curriculum that is not in text books, promotion of health and nursing philosophy are considered as important features in making a student to learn the empowerment approach in clinic. Similarly the study by Leena Liimatainen MSc RN, Marita Poskiparta PhD MEd, Pivi Karhila MSc RN & Auli Sjgren MNSc RN revealed that half of the students are able to reach the critical consciousness that is needed for using knowledge gained while education in practice. Some of them remained at the level of consciousness and some of them reached the level of reflection. This study indicates that the empowerment approach for promotion of health needs critical reflection. The effective evaluation of tools of reflective learning is needed to learn from practice with critical reflection. In a study conducted in Portugal 69.1 percent of nurses studied expressed a general conception, 25 percent were purely participative and 44.1 percent were just participative.1 The nurses expressions are normative and centred in knowledge transmission and behavioural change. About 88 percent of nurses said that they carried HEHP practices. The remaining were carrying often and always the practices regarding the PHC specific areas and about school health. The type of HEHP activities are 1. Health of elders, 2. Health of mother and child, 3. Family planning and 4. Community health along with school health. Majority of nurses stated that they had continuous HE training in the course of education. Even they do feel that they need still more HE training and asked for topics they needed. The process of collecting and analysing the data and the need of communication skills were also felt by the nurses as a tool in using knowledge in practice. From the interviews of nursing students it is evident that the contextualisation and implementation of HEHP activities are needed. Some Hypotheses were made as a result of functioning of nurses and their feelings about the needs of HE training. The result suggested that HE training is necessary but not sufficient for changing their concept about health education and promotion of health. Student nurses must be cautious while making generalisations form one context to another. The aspects of the host organisation, staff, experience, morale and competing authorities must be taken into consideration. The aspects of the system like socio economic, cultural and literacy levels along with place of residence were to be considered to apply the knowledge gained in education for practice. One more thing the nurses will keep in mind is applicability of knowledge. 1 It is so because the central issue will be the mode of application of results of a study, review or training. Effectiveness of the application will be determined under practical conditions, where the nurses find it difficult to apply the knowledge gained during education. Here the critical thinking will make relevant thoughts and enable a person to apply knowledge accordingly. Feasibility is another aspect which can be replicated in a given setting. It includes cost as well as non cost contexts. Expertise, training, timely intervention are the needs of feasibility. By describing the evidence with respect to relevant domains to the application of public health and health promotion interventions to patients, nurses can enhance their knowledge even through practice. This mode of thinking makes nurses to understand through interaction. References: The references were presented in following format. Name of the author, year, title, publisher or sponsor, edition information if vilble, type of media, date retrieved, website address. 1. Leena Liimatainen, Marita Poskiparta, Auli Sjgren1, Tarja Kettunen and Pivi Karhila, 2001, Investigating student nurses' constructions of health promotion in nursing education, Health Education Research, Vol. 16, No.1, electronic, 19-08-06, http://her.oxfordjournals.org/cgi/content/full/16/1/33 2. Leena Liimatainen, Marita Poskiparta, Auli Sjgren, 1999, Student Nurse and Reflective Health Promotion Learning in Hospital, Education-Line, ,electronic, 19-09-06, http://www.leeds.ac.uk/educol/documents/000001151.htm 3. Leena Liimatainen MSc RN, Marita Poskiparta PhD MEd, Pivi Karhila MSc RN & Auli Sjgren MNSc RN, 2001, The development of reflective learning in the context of health counselling and health promotion during nurse education, Blackwell publishing, Vol34, issue 5, electronic, 19-09-06, http://www.blackwell-synergy.com/doi/abs/10.1046/j.1365-2648.2001.01794.xjournalCode=jan 4. Amncio Carvalho, Escola Superior de Enfermagem de Vila Real, Portugal Graa Carvalho, Universidade do Minho, Portugal, , Portuguese nurses' conceptions of their health education (HE) training and their felt needs of HE, University of Minho, ,electronic, 19-09-06, https://repositorium.sdum.uminho.pt/bitstream/1822/4664/1/Nurses+Health+Ed+concept.pdf#search=%22three%20models%20to%20health%20education%20by%20Tones%20and%20Tilford%2C%20patient%2060%20years%20old%22 5. .Peles Biswalo, 2001, The systems approach as a catalyst for creating an effective learning environment, Convergence, vol 34, issue1, electronic, 19-09-06, http://www.umsl.edu/technology/frc/pdfs/systems_approach_in%20DL.pdf#search=%22the%20theory%20of%20andragogy%2C%20teaching%2C%20learining%20activity%20facilitated%20by%20student%22 6. Nicki Jackson and Elizabeth Waters, 2005, Systematic reviews of health promotion and public health interventions, Cochrane collaboration, April, electronic, 20-09-06, www.vichealth.vic.gov.au/cochrane 7. Alyson Taub, EdD, CHES, 2001, Second International Symposium on the Effectiveness of Health Promotion Toronto, Canada, electronic, 20-09-06, www.utoronto.ca/chp/download/2ndSymposium/ATaub.doc 8. Homerton School of Health Studies Dr. Tessa Muncey John Adams Julie Smith Dr. Joy Bray Charlotte Bates, 2005, Making research accessible conference, APU, ,electronic, 20-09-06, http://www.health-homerton.ac.uk/research/files/mraposter.pdf#search=%22%20with%20clients%2C%20conducted%20in%20clinical%20practice%2C%20three%20models%20to%20health%20education%20by%20Tones%20and%20Tilford%22 Read More