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Nurse Education in Practice 14 (2014) 447e448

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Nurse Education in Practice

journal homepage: www.elsevier .com/nepr

Guest Editorial

The importance of integrating active learning in education

Each year, it becomesmore andmore evident that students havedifficulty sitting in place for an entire lecture without lookingbored. Bunce et al., (2010) claim that data suggests students don'tpay attention in lectures for more than 10e20 min. Each day teach-ers notice students daydream, having side conversations, gazingoff, doing other school work, sleeping and even texting during theirclass time which leads most teachers to take this lack of payingattention in their class personally (Weimer, 2014).

The majority of students today have been raised in a generationof advanced technological devices. One such device is the cellphone. Most students in class now carry the updated version thesmart phone. Many educators view student cell phones as learninghindrances while some educators are looking to use the cell phonesto enhance student learning. The Pew Internet Project (2010) foundthat among the schools that allowed students to bring in a cellphone, 71% of students used their phones in the classroom eitherby sending or receiving a text message and surprisingly even thoseschools that did not allow the students to bring in a cell phones toschool 58% of their students reported receiving or sending a textmessage during school. So if even banding the cell phone in classwill do little to deter them from using them, why not encouragedthe students to take out their cell phones during class and actuallyhave them use them for learning.

A smart phone is capable of accessing all kinds of information atthe touch of a finger. It is common for each student to have their cellphonewith them in class. In fact, in a class of 32 students, I recentlyasked if anyone did not have a smart phone with them and not onestudent raised their hand even though I am sure many of themprobably thought I was going to say don't bring them again to class.However, I did see a look of surprise when I asked the students tobring their phones to class each week because we would be usingthem to participate in learning activities. There are times that it isnecessary to ask students to please shut their phones off duringexams or a particular lecture. It appears cell phones are here tostay and will probably advance to become even more appealingto students so educators need to find innovative ways to actuallyuse the cell phone, other technology advances and active learningactivities in the classroom. Today, teachers are pressured withkeeping students not only interested in the lectures but that theylearn the course material. Students can benefit greatly from classesthat incorporate active learning activities.

According toMichael (2006) there is a need to reform our teach-ingmethods in every level of our science courses and in every disci-pline. Nursing is a discipline that relies on students having efficientscience knowledge prior to enrolling in core nursing curriculumcourses. Reform is needed in nursing education as well. The dayof lecturing by standing in the front of the classroom using power

http://dx.doi.org/10.1016/j.nepr.2014.06.0011471-5953/© 2014 Elsevier Ltd. All rights reserved.

points is no longer an effective method of teaching. Educatorsneed to be active teachers that seek innovative ways to improvestudent learning and critical thinking. Incorporating effective activelearning activities takes a lot of thought and planning by theeducator but the end result is the students will be engaged to learn.According to Prince (2004) active learning includes instructionalactivities that engage students. Faust and Paulson (1998) definesactive learning as an engaging activity other than that of passivelylistening to teachers lecture. Michael (2006) further defined activelearning to include the fact that research has proven its effective-ness and that it actually forces the student to reflect on their ideasand look at just how they used these ideas.

Finding innovative active learning methods can help nursingstudents learn course material and reflect on their choices. Thereare a few good examples of effective learning activities, I use inmy classroom. Below are five active learning activities that I havefound to be effective to help prevent students from becoming boredwhile in class.

1. I provide students with case studies to engage students to beactive participants in learning. I first explain to the class thatwhen I say OK now we are going to do a case study, they are totake out a pen and a piece of paper to record information theyfeel is important if they were the triage nurse in the ER taking apatient history. The following is an example of a simple casestudy used to teach collecting subjective and objective datafollowed with assessment questions. The case study might looklike this one: An 89year old female is brought into the hospi-tal's ER via ambulance. The EMS reports that the patient wasfound unresponsive by her husband, who verbalized his wifehas had a cold for a few days and was fine when she wokeup this morning. He reports she has a history of Diabetes andHTN. You are the triage nurse and find that: the patient is nowawake but lethargic and her vital signs are: T99, P94 RR20, B/P162/98.

I then ask students to record both subjective and objective datafollowed by asking the following questions:

� What were the abnormal findings?� What questions will you ask the patient's husband?� What questions will you ask EMS?� What questions will you ask the patient?� What medical diagnosis are you thinking the patient has?� What nursing diagnosis will you give the patient?� What nursing interventions would you do?� How are you prioritizing the care for the patient?

Guest Editorial / Nurse Education in Practice 14 (2014) 447e448448

2. Technology advances can be effective active learning tools in theclassroom. For instance if today's lecture is going to cover: thetransmission, prevention and isolation precautions used for in-fections I have students take out their smart phones to activelylearn about them. But, this takes planning so you provide thestudents with a specific task to accomplish. An example is, whenteaching about Hepatitis, I ask students to take out their smartphones and look up Hepatitis A-E and write down how each oneis transmitted, how we can prevent each one from spreadingand what isolation techniques we would use. I am able to wit-ness students enjoy using their phones to access scholarlysources and take an active role in their learning. I have yet towitness students falling asleep or appearing bored during thisactivity.

3. Constructing test questions can be a challenging task but at thesame time is a great opportunity for active learning to occur. Iassign students a course topic and then have them construct 3-5NCLEX (National Council Licensure Examination) style testquestions and ask them to design the questions so that theyhave to use critical thinking to answer the question and notsolely knowledge based questions. I also have the student pro-vide a rational for their answers using the text book. They thenwill share their questions with the class and actually have toexplain why their answer was correct which usually leads tomuch debate by the class. This is good active learning activity tohelp students take exams, learn course material, use criticalthinking, learn how to access scholarly sources, provide arational and defend their answer using evidenced based practiceand use peer teaching in the process. This is actually a lot of funfor students and they may even get a taste of just how hard it isfor educators to construct exams.

The next two active learning activities utilize the knowledgethat students learn effectively from each other and peer teachingis now recognized as a great way for students to learn. “Byassuming the responsibility of teaching their peers, students notonly improve their understanding of course content, but alsodevelop communication skills, teamwork, leadership, confidenceand respect for peers that are vital to developing professionalismearly in their medical careers” (Krynch et al., 2005 p. 296).

4. Assigning students to work in groups of 4e6 allows students tolearn course material and learn how to effectively work as ateam. Group assignments can be on a variety of course topics.For example when teaching Nursing Leadership and Manage-ment, the topic of Nursing Scheduling & Budgeting can be a bitdry so for this a group activity is preferred. I provide each groupwith a different unit in the hospital to create a staff schedule andbudget. For instance one group will be assigned a Medical/Sur-gical unit with 32 patients while another group is assigned aCritical Care unit with 16 patients and another group is assigneda Recovery Room with approx. 6 patients and so forth until allthe groups have their assignment. Each unit will have differentgoals, objectives, staffing and budgeting needs. The groups haveto plan for what they would need for nursing, assistivepersonnel, supplies and so forth and then plan a staffingschedule and budget for the unit. Once they are done theypresent to the class and each student writes down anything theyfeel the group may have left out or over budgeted for. It really isa fun activity and allows the student to recognize what it takesto run a nursing unit, the special needs each unit has whilekeeping the student engaged actively learning.

5. Again, group work can provide students with active learningwhen covering a dry subject matter. For instance, if teachingabout Change Theories, I will first ask the class to list whatproblems they foresee arising in an acute care hospital whileadding some problems that may have not been mentioned suchas: staffing issues, increased sick calls, increased fall rates,increased infection rates, poor patient and nurse satisfactionrates are among a few. The student's then divide into groups andpick one of the problems requiring change and the changetheory they will apply to improve/address the problem. Eachgroup will present their work to the class thus allowing studentsto use peer teaching an effective active learning method.

Conclusion

It is challenging to teach in today's fast paced environment yet itcan be a rewarding experience when you see students engaged inyour classroom actively learning. As educators we need to shareour innovative effective active learning methods. Educators haveresponsibility not only to the schools inwhich theywork but to stu-dents and the communities they work. Nursing is a profession thatrequires students to be not only be caring and compassionate but tounderstand the complexities of the human body, the multitude ofdisease processes, the various treatment modalities, disease pre-vention strategies and most importantly to have the ability to putall of this together in order to apply critical thinking whenproviding patient care. One way to achieve all of this is by havingstudents engaged in the classroom thorough the use of activelearning activities. Educators need to think out of the box especiallyin a time when technology resources are not economically feasiblefor many schools to invest in. For instance, instead of viewing cellphones in the classroom as a hindrance to learning see it as acost-effective learning tool and even as a mini computer in whichstudents have already invested time and money into and mostlikely have it ready to go in their pocket. The cell phone is oftenreferred to as a smart phone for a reason and has potential to bean effective learning tool both in the classroom as well as outsidethe classroom. Nursing educators need to provide active learningmethods that reflect real-life in order to engaged students to learnin order to one day provide competent compassionate care toothers.

References

Bunce, D.M., Flens, E.A., Neiles, K.Y., 2010. How long can students pay attention inclass? A study of student attention decline using clickers. J. Chem. Educ. 87(12), 1438e1443.

Faust, J.L., Paulson, D.R., 1998. Active learning in the college classroom. J. Excell. Coll.Teach. 9 (2), 3e24.

Krynch, A., March, C., Bryan, R., Peake, B., Paulina, W., Carmichael, S., 2005. Recip-rocal peer teaching: students teaching students in the gross anatomy labora-tory. Clin. Anat. 18 (2), 296e301.

Michael, J., 2006. Where's the evidence that active learning works? Adv. Physiol.Educ. 30 (4). Retrieved at: http://advan.physiology.org/content/30/4/159.short.

Pew Research Internet Project, 2010. Teens and Mobile Phones. Retrieved at: http://www.pewinternet.org/2010/04/20/teens-and-mobile-phones-3/.

Weimer, M., 2014. Students and attention: an interesting analysis. Fac. Focus 26(10). Retrieved at: http://www.facultyfocus.com/articles/teaching-and-learning/students-attention-interesting-analysis/.

Maureen Kroning, Associate ProfessorNyack College, 1 South Blvd Nyack, NY 10960, USA

E-mail address: maureen.kroning@nyack.edu.