How students learn

Interesting links

The Nature of Learning: Using Research to Inspire Practice. 

Practitioner Guide from the Innovative Learning Environments Project. Centre for Educational Research and Innovation. 

Interesting resources

Brandon, A & All, A 2010, 'Constructivism theory analysis and application to nursing programs', Nurse Education Perspectives, vol. 31(2), pp. 89-92.

Candela, L, Dalley, K & Benzel-Lindley, J 2006, 'A case for learning-centered curricula', Journal of Nursing Education, vol. 45(2), pp. 59-66.

"... what the student does is actually more important in determining what is learned than what the teacher does."  Thomas Shuell

The are a number of approaches which aim to optimise how and how much students actually learn from a teaching activity, but one of the most important is to develop student-centered learning strategies, which are based on the foundation of constructivism. 

Most modern tertiary institutions actively practice (or claim to practice) program delivery methods which encourage students to take an active role in creating the learning and assessment processes. 

Student-centered learning strategies shift the focus of activity from the teacher to the learners, and are particularly relevant to tertiary and professional education, because they foster motivation and incentive to learn. In acting as a facilitator guiding the students, rather than just instructing them, the teacher is allowing the learners take an active part in deciding what they learn, how they learn and how they can evaluate what they have learnt. 

Ideally, this means that the learners have more responsibility and ownership of their learning, and are not simply passive ‘vessels’ receiving knowledge from the teacher. 

Student-centered strategies emphasise each student’s interests, abilities and learning style. Where these types of strategies have been actively adopted in tertiary programs, the evidence suggests that the students have developed greater skills for independent problem solving, critical thinking and reflective thinking. The approach has also increased their confidence in their knowledge and skills. 

The input which the students have in their learning also have implications for assessment – in a student-centred classroom, they will be more involved in deciding how to evaluate and demonstrate their learning. 

Putting it into practice

Learning contracts are mutual agreements between teachers and students which state explicitly what a learner will do to achieve specific learning outcomes, and how their learning will be measured and evaluated. 

They foster an increased responsibility for their own learning. Contracts can include learning expectations, learning resources, learning experiences, documentation and other information such as designated evaluators, evaluation criteria and timelines. 

Source: Teaching Strategies Promoting Active Learning in Healthcare Education 

Interesting resources

Azer, S 2013, Making sense of clinical teaching: A hands-on guide to success, Boca Raton, CRC Press/Taylor & Francis.

Bradshaw, M & Lowenstein, A 2014, Innovative teaching strategies in nursing and related health professions, Jones and Bartlett Learning.

Active learning is the process in which students engage in activities such as reading, writing, discussion, or problem solving that promote analysis, synthesis, and evaluation of class content. Cooperative learning, problem-based learning, and the use of case methods and simulations are some approaches that promote active learning. 

When students are actively engaged, they think deeper about the course content, and enjoy their learning. This can be through a range of activities: group work, project work, interactive online activities, peer teaching, and so on. Students must be actively participating in and reflecting on the activities to enhance their higher order thinking capabilities. 

The key principles of active learning are:

1. The task has purpose and relevance to the students.
2. The students are able to reflect on the meaning of what they have learnt.
3. The students can negotiate goals and methods of learning with the teacher.
4. The students can critically evaluate different ways and means of learning the content.
5. The complexity of the learning tasks is comparable to professional contexts and real life.
6. The tasks are situation-driven: that is, the need of the situation is taken into consideration in order to establish the learning tasks.

Adapted from Barnes, D 1989, Active Learning, Leeds University TVEI Support Project. 

Putting it into practice: Applications in Health Sciences

1. Health educators can use questioning strategies to develop critical thinking, decision making, and problem solving in students. Word your questions so that they challenge the students to use a higher level of cognitive development (analysing, evaluating and creating). For example, asking a student to define a type of x-ray would test their ability to remember, but asking a student to assess a request to perform that x-ray on a patient with particular symptoms would test ability to evaluate, and prompts the student to think more deeply about the material. 

2. Self-evaluation is a type of self-directed learning which   allows students to assess their own performance. As a result, they become more independent, and are able to identify knowledge and understanding weaknesses.  The aim of the self-evaluation activity is to assist students to identify strengths and weaknesses in their learning, to set their own performance goals, and to increase their satisfaction with their learning - all key elements of the clinical and professional work environments. However, be aware that students can tend to be overly critical of their own performance 

Adapted from https://www.scribd.com/document/271833630/Teaching-Strategies-Promoting-Active-Learning-in-Healthcare-Education

Interesting resources

Active learning processes used in US Pharmacy Education

Wilson, L & Rockstraw, L 2012, Human simulation for nursing and health professions, Springer Pub Co, New York, NY.

Collaborative learning encompasses a whole host of learning approaches which use the group and team approach to student work. When the group work activities are carefully planned, we are aiming for cooperative learning, in which students work together to accomplish a common academic goal.

Effective collaborative learning will optimise peer learning, in which students learn from and teach each other.

Examples of collaborative learning activities are: group problem solving tasks; team writing assignments, with the aim of a group-authored document; and reciprocal teaching, in which students act as teachers to lead discussion, summarize material, ask questions, and clarify material. These can all be incredibly effective approaches in the classroom, and it should be remembered that teamwork is an important element in equipping students for success in industry ... but it needs to be carefully set up and prepared. 

When planning collaborative learning activities, such as group carefully consider the goals of the activity, to make sure that there is sufficient depth for each group member to have meaningful input.

Try to shape the activity to allow for various group personalities (such as the creative contributers, finishers, etc) each to have the opportunity to shine. Note that you will need to work out how to fairly assign marks to the final product. The self and peer assessment strategy, in which students assess each others' contributions using a list of criteria, may help here, especially if the students have been involved in establishing the criteria used. 

It's also important to remember that students need to be taught how to work together productively in groups - many of them don't find group work easy, and groups that are thrown together do not necessarily succeed. They must develop the skills to maintain a positive interdependence - in which each students depends on the others for success - along with individual accountability. Groups must be set , social skills, group processing, and appropriate grouping.

A number of collaborative teaching spaces have been set up throughout the UniSA campuses, in which the physical layouts and technical sharing functions have been especially created to optimise group work and collaborative learning. At the City East campus, there are two Collaborative Teaching Spaces: in the library, in room C4-08, and room C6-26. You can see an image of room C4-08 below. 

Putting it into practice: Examples of successful collaborative learning in Health Sciences

Collaborative learning in the health sciences can be used in the context of student placement. Groups can be arranged for students to come together to reflect on, and find possible solutions to, any issues that arise on their placement.

The teacher should act as a facilitator if only to encourage all students to find their voice and ensure that the potential solutions that arise are acceptable solutions for the problems faced. Students should collectively problem-solve, drawing on their own experiences, learning and understanding to create better outcomes. 

(Adapted from: Myron, R, French, C, Sullivan, P, Sathyamoorthy, G, Barlow, J & Pomeroy, L 2018, 'Professionals learning together with patients: An exploratory study of a collaborative learning Fellowship programme for healthcare improvement', Journal of Inter-professional Care, vol. 32, no. 3, pp. 257-265.)

Another example of cooperative learning is adopting a team approach to learning a particular concept. The concept could be broken down in to sections whereby each member of the team needs to learn and become the ‘expert’ of a particular section.

The ‘expert’, once mastering the content, needs to identify an effective way to engage and instruct the group, so they too can become ‘experts’. This strategy requires the student to teach others, an active learning strategy that achieves higher information retention rates than more passive learning strategies.

(Adapted from: Cinelli, B, Symons, C, Bechtel, L & Rosecolley, M 1994, 'Applying cooperative learning in health-education practice’, Journal Of School Health, vol. 64, no. 3, pp. 99-102.)

Interesting resources

Sydney University: Self and Peer Assessment

A team-based learning guide for students in health professions education

Team-based learning: A transformative use of small groups in college teaching

Tolsgaard, MG 2016, 'Collaborative learning of clinical skills in health professions education: the why, how, when and for whom' Medical Education vol. 50(1), pp. 69-78.

“People learn more deeply from words and pictures than from words alone”.

The quote above is true ... however, just putting text and pictures together does not necessarily make for effective learning.

When we are using a variety of media in our teaching (test, images, video, interaction), we need to consider the best way for students to learn.

The Cognitive Theory of Multimedia Learning gives guidance for informed multimedia instructional messages.

This theory is based on three assumptions:

• Humans have separate channels for processing visual and auditory information (dual channels)
• Humans are limited in the amount of information that can be processed in each channel at one time (limited capacity)
• Humans engage in active learning by attending to relevant incoming information, organising selected information into coherent mental representations, and integrating mental representations with other knowledge (active processing)

For example, information presented to a student using both auditory (narration) and visual (text) displays requires the student to process this information using both channels. However, the student's ability to process is limited. If a students is receiving information from both channels, his or her mind is forced to be selective with the information it chooses to keep, and which bits of information he or she should make connections between.

Putting it into practice: Instructional goals for multimedia instruction

The table below offers a brief overview of three instructional goals in multimedia learning, bearing in mind the assumptions we discussed above. You might find it useful to consider the various techniques listed in the third column when creating a multimedia learning activity.

Interesting resource

Mayer, R 2014, 'Cognitive theory of multimedia learning', Richard Mayer, The Cambridge Handbook of Multimedia Learning, Cambridge University Press, Cambridge, UK, pp. 43-71

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Adapted from: Mayer, R 2014, Cognitive theory of multimedia learning, Richard Mayer, The Cambridge handbook of multimedia learning, Cambridge University Press, Cambridge, UK, pp. 43-71