CRI TI CAL I NCI DENTS I N THE TEACHI NG-LEARNI NG PROCESS OF A NURSI NG COURSE
THROUGH THE PERCEPTI ON OF STUDENTS AND FACULTY
1Adr ian a Valon go Zan i2 Mar ia Suely Nogueir a3
Zan i AV, Nog u eir a MS. Cr it ical in cid en t s in t h e t each in g - lear n in g p r ocess of a n u r sin g cou r se t h r ou g h t h e per cept ion of st udent s and facult y. Rev Lat ino- am Enfer m agem 2006 set em br o- out ubr o; 14( 5) : 742- 8.
The t eaching- lear ning pr ocess is com plex and leav es m any quest ion m ar k s, m ainly w hen one t hink s abou t qu alit y . Th er efor e, t h is st u dy aim s at iden t ify in g fact or s t h at in t er fer e posit iv ely or n egat iv ely in t h e t each in g - lear n in g p r ocess, t h r ou g h t h e p er sp ect iv e of st u d en t s an d f acu lt y of t h e Nu r sin g cou r se at t h e Un iv er sidade Nor t e do Par an á- UNOPAR. Th is descr ipt iv e st u dy w it h a qu alit at iv e appr oach w as car r ied ou t t hrough t he crit ical incident s t echnique. Thirt y- six facult y and 140 st udent s part icipat ed. Dat a analysis revealed t hat t he st udent s m ent ioned 435 crit ical incident s relat ed t o t he cat egory facult y behavior, being 317 negat ive references and 118 posit ive. According t o t he facult y m em bers’ report s, t he cat egory int eract ion wit h t he group pr oduced 5 8 r efer ences, being 1 0 posit iv e and 4 8 negat iv e. An adequat e t eaching- lear ning pr ocess r equir es good facult y - st udent and st udent - st udent r elat ionships, fav or ing good int er act ion and efficient lear ning.
DESCRI PTORS: t eaching; lear ning; com m unicat ion; nur sing
I NCI DENTES CRÍ TI COS DEL PROCESO ENSEÑANZA-APRENDI ZAJE DEL CURSO DE
PREGRADO EN ENFERMERÍ A SEGÚN LA PERCEPCI ÓN DE ALUMNOS Y DOCENTES
El pr oceso de enseñanza- apr endizaj e es com plej o y pr esent a var ias incógnit as, pr incipalm ent e cuando se piensa en la calidad. Así, el obj et ivo de est e est udio fue de ident ificar los fact ores que int erfieren posit iva o negat ivam ent e en el pr oceso de enseñanza- apr endizaj e, según la visión de alum nos y pr ofesor es del cur so de pregrado de Enferm ería de la Universidad Nort e del Paraná - UNOPAR. Fue llevado a cabo un est udio descript ivo con aproxim ación cualit at iva, a t ravés de la “ t écnica de incident es crít icos” . Form aron part e de est e est udio 36 p r of esor es y 1 4 0 alu m n os. Desp u és d el an álisis d e los d at os, se ob ser v ó q u e los alu m n os r elat ar on 4 3 5 incident es cr ít icos r elacionados a la cat egor ía conduct a del pr ofesor , siendo 317 r efer encias negat iv as y 118 posit iv as. Con r elación a los r elat os de los pr ofesor es, se v er ificó que la cat egor ía int er acción con el gr upo pr esent ó 58 r efer encias, siendo 10 posit iv as y 48 negat iv as. Por lo t ant o, par a que el pr oceso de enseñanza-ap r en d izaj e ocu r r a d e f or m a ad ecu ad a, n ecesit a d e u n a b u en a r elación en t r e p r of esor - alu m n o y alu m n o-alum no, fav or eciendo de esa m aner a una buena int er acción y un apr endizaj e eficient e.
DESCRI PTORES: en señ an za; apr en dizaj e; com u n icación ; en f er m er ía
I NCI DENTES CRÍ TI COS DO PROCESSO ENSI NO-APRENDI ZAGEM DO CURSO DE
GRADUAÇÃO EM ENFERMAGEM, SEGUNDO A PERCEPÇÃO DE ALUNOS E DOCENTES
O pr ocesso en sin o- apr en dizagem é com plex o e apr esen t a v ár ias in cógn it as, pr in cipalm en t e qu an do se pensa em qualidade. Sendo assim , o obj et ivo dest e est udo foi ident ificar os fat ores que int erferem posit iva ou n egat iv am en t e n o pr ocesso en sin o- apr en dizagem , segu n do a v isão de alu n os e pr ofessor es do cu r so de gr adu ação em En fer m agem da Un iv er sidade Nor t e do Par an á - UNOPAR. Tr at a- se de est u do descr it iv o com abordagem qualit at iva at ravés da t écnica de incident es crít icos. Fizeram part e do est udo 36 professores e 140 alunos. Após a análise dos dados obser v ou- se que os alunos r elat ar am 435 incident es cr ít icos r elacionados à cat egor ia condut a do pr ofessor , sendo 317 r efer ências negat iv as e 118 posit iv as. Em r elação aos r elat os dos pr ofessor es, ver ificou- se que a cat egor ia int er ação com o gr upo apr esent ou 58 r efer ências, sendo 10 posit ivas e 4 8 n egat iv as. Por t an t o, o pr ocesso en sin o- apr en dizagem , par a ocor r er de f or m a adequ ada, n ecessit a de bom r elacionam ent o pr ofessor - aluno e aluno- aluno, fav or ecendo a boa int er ação e apr endizado eficient e.
DESCRI TORES: en sin o; apr en dizagem ; com u n icação; en f er m agem
1
Art icle ext ract ed from t he Mast er ’s Thesis; 2 Facult y, Universit y of Nort h Paraná, Mast er ’s st udent , e- m ail: adriana.zani@unopar.br; 3 Assist ant Professor, e-m ail e-m snog@eerp.usp.br. Universit y of São Paulo at Ribeirão Pret o College of Nursing, WHO Collaborat ing Cent re for Nursing Research Develope-m ent
I NI TI AL CONSI DERATI ONS
T
h e t e a c h i n g - l e a r n i n g p r o c e s s a n d com m unicat ion hav e alw ay s been closely r elat ed, ast here is no way of t alking about t he t eaching- learning
process wit hout t alking about com m unicat ion and
vice-v er sa. I n or d er t o t each , w e n eed com m u n icat ion ,
w h e t h e r v e r b a l l y o r n o n v e r b a l l y. Th e t e a ch i n g
-l e a r n i n g p r o c e s s i s b a s e d o n t h e e x c h a n g e o f
k n o w l e d g e a n d e x p e r i e n ce s a m o n g t h e su b j e ct s
i n v o l v ed , a n d co m m u n i ca t i o n i s a n i n d i sp en sa b l e
elem ent for t his exchange t o occur.
As nur ses and facult y m em ber s in a nur sing
cour se, w e hav e oft en been confr ont ed w it h nur sing
st udent s w ho m ent ioned learning difficult ies, deriving
f r om p r ob lem s t o u n d er st an d t h e con t en t s, eit h er
because t hey did not hav e basic k now ledge, did not
a g r e e w i t h t h e t e a ch e r ’ s d i d a ct i cs o r p r e se n t e d
difficult ies t o r elat e w it h t he t eacher. Ther efor e, t he
r eal m eaning of t he t eaching- lear ning pr ocess needs
t o be descr ibed.
I n p r in cip le, t h e w or d t each in g m ay seem
si m p l e, as ev er y b o d y, w h et h er ( s) h e i s a t r ai n ed
e d u c a t o r o r a n a m a t e u r, t e a c h e s s o m e t h i n g t o
som ebody t hroughout his/ her life. Each t im e a m ot her
explains t o her child how t o cross t he st reet , or when
one person explains t o anot her how t o reach a cert ain
dest inat ion, ( s) he is also t eaching.
A l a r g e n u m b e r o f p e o p l e t e a ch , w i t h o u t
obtaining a degree or taking courses in didactics, without
knowing how, t he m ost incredible t hings, such as t he
ability to speak a language and, together with that, the
m ysteries of the world’s com position and architecture( ¹ ).
Hence, t he act of t eaching is a com m unicat ion
act par excellence, an act of sharing knowledge, ideas,
f eelin gs, belief s or v alu es ch ar act er ist ic of a social
group’s cult ure. For t housands of years, t eaching has
b e e n co n si d e r e d t h e m a i n sy st e m t o p r e se r v e a
g r o u p ’ s cu l t u r a l h e r i t a g e , t r a n sm i t t i n g i t t o n e w
m em b er s an d i n ser t i n g t h em i n t o co m m o n l i f e(²).
How ev er, w e k n ow t h at lear n in g d oes n ot h ap p en
t hr ough copy ing or m em or izing cer t ain cont ent s, but
t hrough t he individual’s past experiences. Learning is
t he pr ocess t hr ough w hich behav ior is m odified as a
r e su l t o f e x p e r i e n ce . I t i s n o t r e st r i ct e d t o t h e
assi m i l at i o n o f co n t en t s an d t ech n i q u es, b u t al so
includes feelings and em ot ions( 3- 4).
I n gen er al, t each in g design at es t h e act iv it y
of t each er s, an d t h e con cep t of t each in g r ef er s t o
t eacher - st udent , w it h lear ning as it s end pr oduct( 5) .
H o w e v e r, l e a r n i n g i s n e i t h e r b a s e d o n
t eacher s’ pedagogical sk ills, nor on t heir specialized
k now ledge about t he subj ect , nor on t heir cur r icular
plan n in g, u se of au diov isu al r esou r ces, pr ef er en ces
and ex posit ions, nor on a lar ge collect ion of book s,
alt hough each of t hese it em s can be used on cert ain
occasions. I nst ead, lear ning is based on t he qualit y
o f at t i t u d es i n t h e p er so n al r el at i o n b et w een t h e
t eacher ( facilit at or) and t he learner ( st udent )( 6). Thus,
t his st udy aim ed t o:
- I dent ify fact ors int erfering posit ively or negat ively in
the teaching- learning process, according to students and
facult y m em bers in an undergraduat e nursing course.
METHODOLOGY
We c a r r i e d o u t a d e s c r i p t i v e s t u d y a n d
adopt ed a qualit at iv e appr oach t o fact or s int er fer ing
i n t h e t e a c h i n g - l e a r n i n g p r o c e s s o f f a c u l t y a n d
st udent s at t he Universit y of Nort h Paraná - UNOPAR,
r e g i st e r e d b e t w e e n 1 9 9 8 a n d 2 0 0 2 . Th e sa m p l e
consist ed of 36 facult y m em bers and 140 st udent s in
t he 2nd, 3rd and 4t h year of t he undergraduat e nursing
co u r se a t UNOPAR, a n d w h o d e m o n st r a t e d t h e i r
av ailabilit y an d in t er est t o par t icipat e in t h e st u dy,
af t er bein g in f or m ed abou t it s obj ect iv es. St u den t s
w er e select ed t h r ou g h con v en ien ce sam p lin g . Th e
n u m b e r o f st u d e n t s a n d f a cu l t y w a s e st a b l i sh e d
t h r o u g h t h e q u a l i t a t i v e r e se a r ch p r i n ci p l e , w h i ch
det erm ines t hat t he research ends when dat a repet it ion
occu r s. Fir st - y ear st u d en t s w er e ex clu d ed b ecau se
t hey had been t ak ing t he Nur sing cour se only for a
shor t t im e.
We u se d t h e cr i t i ca l i n ci d e n t t e ch n i q u e ,
d e f i n e d a s “ a se t o f p r o ce d u r e s t o co l l e ct d i r e ct
obser v at ion s of h u m an beh av ior, so as t o f acilit at e
t h eir p ot en t ial u se t o solv e p r act ical p r ob lem s an d
dev elop br oad psy chological pr inciples, also out lining
p r o ced u r es f o r co l l ect i n g o b ser v ed i n ci d en t s t h a t
p r e s e n t a s p e c i a l m e a n i n g a n d f o r f i n d i n g
sy st em at ically defined cr it er ia” ( 7).
I n c i d e n t i s “ a n y h u m a n a c t i v i t y t h a t i s
sufficient ly com plet e in it self t o allow for infer ences
and pr ov isions about t he per son per for m ing t he act .
I n or der t o be cr it ical, an in ciden t m u st occu r in a
sit u at ion w h er e t h e pr oposit ion or in t en t of t h e act
seem s r easonably clear t o t he obser v ed, and w her e
it s consequences are sufficient ly defined, so as t o leave
Som e aut hors have used t he crit ical incident
t echnique t o ident ify t he difficult ies and pr oblem s of
pat ient s subm it t ed t o sealed int ernal radiot herapy. The
r e su l t s f o u n d t h a t t h e p r o b l e m s a n d d i f f i cu l t i e s
obser v ed and r epor t ed by t hese w om en w er e m ainly
r elat ed t o t he im posit ions inher ent in t r eat m ent , and
t hat t he nurse’s role was im port ant in planning nurse
scar e in sealed in t er n al radiot h erapy, based on t h e
u n d e r s t a n d i n g o f t h e p r o b l e m s a n d d i f f i c u l t i e s
experienced by wom en subm it t ed t o t his t reat m ent( 8).
D a t a w e r e o b t a i n e d t h r o u g h t h e c r i t i c a l
incident t echnique. We used t w o inst r um ent s, one t o
obt ain dat a from st udent s and anot her t o collect dat a
fr om facult y m em ber s. The inst r um ent s consist ed of
t w o p ar t s: t h e f ir st con t ain ed q u est ion s r elat ed t o
su bj ect s’ ch ar act er ist ics, w h ile t h e secon d basically
consist ed of t w o guiding quest ions, w hich allow ed us
t o iden t if y posit iv e an d n egat iv e aspect s r elat ed t o
t h e t each in g- lear n in g pr ocess in t h e u n der gr adu at e
n u r si n g co u r se , a cco r d i n g t o co u r se st u d e n t a n d
f acu lt y m em ber s’ per cept ion s.
I n t er v iew s w er e h eld at t h e st u dy r oom of
t h e n u r sin g Coor d in at ion , r esp ect in g st u d en t s an d
t eacher s’ availabilit y, int er est and pr ivacy.
Aft er guarant eeing anony m it y, in com pliance
wit h guidelines and regulat ory st andards for research
i n v o l v i n g h u m a n b e i n g s ( Re s o l u t i o n 1 9 6 / 9 6 ) ,
i n t er v i ew s t o o k p l ace. Fi r st , p ar t i ci p an t s r ecei v ed
quest ions about t heir charact erist ics. Then, t hey were
a sk e d i n t w o q u e st i o n s t o t a l k a b o u t si t u a t i o n s
o ccu r r ed d u r i n g cl assr o o m , t r ai n i n g o r l ab o r at o r y
act iv it y. The m eaning of incident s and t he definit ion
of t he t er m cr it ical w er e ex plained.
Th e r esear ch er h ad t o giv e som e ex am ples
of in cid en t s f or t h e sak e of b et t er u n d er st an d in g ,
t ak in g car e n ot t o r efer t o ex am ples r elat ed t o t h e
act iv it y u n der st u dy. Besides st an dar ds gu idin g any
research, in t he case of crit ical incident s, cert ain care
n eed s t o b e t ak en , su ch as: clear ly ex p lain in g t h e
m eaning of crit ical incident s; clarifying t he connot at ion
of t he t erm crit ical; giving one or t w o exam ples t hat
are not direct ly relat ed t o t he developed act ivit y and
ex plicit ly st at in g t h e cr it er ia t h at m ade u s con sider
t he r epor t ed episodes as cr it ical incident s( 9).
D at a an al y si s co m p l i ed w i t h f o u r cr i t er i a:
reading and listing of reports; identification of elem ents
involved in t he crit ical incident ( sit uat ion, behavior and
consequence) ; grouping of reports and categorization( 10).
Fir st , w e r ead t h e in t er v iew s an d ex t r act ed
t he crit ical incident s inherent in t he t eaching- learning
pr ocess, cont aining posit iv e and negat iv e r efer ences,
i n l i n e w i t h n u r s i n g s t u d e n t s a n d t e a c h e r s ’
perspect ives. Then, w e carried out a second reading,
sear ch in g f or con f u sed or u n clear r ep or t s( 7 ). Th u s,
eigh t r epor t s w er e ex clu ded becau se t h ey w er e n ot
consider ed t o be cr it ical incident s.
Aft er exhaust ive analysis, t he crit ical incident s
w er e cat egor ized in t er m s of sim ilar it ies, consider ing
aspect s r elat ed t o t he t eaching- lear ning pr ocess and
defined as t he follow ing cat egor ies: t eacher behav ior
as per ceiv ed by st udent s, t ot aling 4 3 5 r epor t s; and
int er act ion w it h t he gr oup as per ceiv ed by t eacher s,
including 58 r epor t s.
RESULTS AND DI SCUSSI ON
We c o l l e c t e d 4 3 5 r e p o r t s r e f e r r i n g t o
t eachers’ behavior according t o st udent s, 118 ( 27.1% )
w i t h p o s i t i v e a n d 3 1 7 ( 7 2 . 9 % ) w i t h n e g a t i v e
r ef er en ces. Teach er beh av ior aspect s w er e gr ou ped
as follow s: t eacher hinder s st udent ’s cr eat ivit y - 133
n e g a t i v e r e f e r e n ce s; t e a ch e r d o e s n o t t a k e t h e
s t u d e n t ’ s l e a r n i n g m o m e n t i n t o c o n s i d e r a t i o n ,
in t er r u p t in g t h is p r ocess - 7 3 n eg at iv e r ef er en ces;
t e a ch e r ’ s a t t i t u d e - 4 3 p o si t i v e a n d 8 9 n e g a t i v e
r ef er en ces; t each er en cou r ag es st u d en t d u r in g t h e
lear ning pr ocess - 36 posit iv e r efer ences; t eacher is
con sid er ed t o b e an id eal ex am p le of p r of ession al
d u e t o h i s/ h e r a ct i o n s - 3 9 p o si t i v e r e f e r e n ce s;
d id act ics im p osed b y t each er in classr oom h in d er s
st udent ’s lear ning - 20 negat iv e r efer ences.
Teacher s should st im ulat e st udent s’ cr it
ical-cr eat iv e cap acit y an d , in t h is r ole, p r om ot e lib er t y
and challenge r eason( 11).
Ho w e v e r, w h e n t h e t e a ch e r h i n d e r s t h e
student’s creativity, this causes negative criticism against
t he t eacher, as confirm ed by t he following report :
“ ...I was in t raining at a hospit alizat ion unit and t he
t eacher had given m e a pat ient who needed t o be washed in bed;
t hen she asked m e t o arrange t he m at erial while she went t o see
t he ot her st udent s, when I was preparing t he m at erial t he nurse
asked m e t o do t he procedure quickly, because t he pat ient was
going t o get a t om ography and t ransport would com e and pick
him up soon; I t ried t o warn t he t eacher but she t old m e t o wait
so, as t here was no t ray available t o t ake t he m at erial, I used t he
lid of a recipient as a t ray and t ook t he m at erial t o t he room , when
I was alm ost finishing t o wash t he pat ient , t he t eacher arrived
washing wit hout her and how could one im agine using a lid as a
t ray, she ordered m e t o st op washing t he pat ient and arrange a
t ray t o cont inue, she didn’t let m e explain anyt hing...”
How ever, w e can ident ify in t his r epor t t hat ,
despit e t he st udent ’s indignat ion, he does not k now
t h e scien t ific pr in ciples of cer t ain t ech n iqu es, as h e
c o n s i d e r s u s i n g a l i d a s a t r a y t o b e a c o r r e c t
pr ocedur e, w it hout w or r y ing about t he pur pose each
m at er ial sh ou ld be u sed for an d it s im plicat ion s for
pat ien t s.
When t he t eacher does not t ake t he st udent ’s
lear ning m om ent int o consider at ion, int er r upt ing t his
p r o ce ss, ( s) h e r e ce i v e s a n e g a t i v e r e f e r e n ce , a s
show n by t he follow ing r epor t :
“ ... m y group had t o present a sem inar, each st udent
had t o do one part , as I was responsible for t yping, t herefore, I
ended up knowing everyone’s part ; I had st udied a lot but , when
I have t o t alk in public, I get desperat e. On t he day of t he sem inar,
when I st art ed t he present at ion, I put up a slide as a t able and,
because I rem ained silent for a couple of seconds, t he t eacher
st art ed t o ask quest ions wit hout st opping, I becam e desperat e
and I couldn’t answ er , t hen she ask ed m e t o sit dow n, she
crit icized m e t o t he ext ent of insinuat ing t hat I wasn’t capable
and st art ed t o t ell all of m y cont ent s and I left t he room t o cry....”
Alt hough t he st udent felt harm ed by how t he
t eacher dealt wit h t he st udent , we observe in t he above
t est im ony t hat t he group did not work t oget her, as t he
st udent referred t o group work, alt hough t hat was not
w h at h appen ed. Each st u den t car r ied ou t a specific
part of t he research, and t he fact t hat t his st udent t yped
ev er y t h in g does n ot m ean t h at sh e u n der st ood t h e
ent ire cont ent s. Group work should not be seen as an
act iv it y t o be r ealized by m or e t han one per son, in
w hich each w ill do his part individually and t hen add
t hat t o t he ot her part icipant s’ cont ribut ions.
Group/ t eam work “ presupposes sharing ideas
and feelings, dialogue and conflict coping”( 12). Teachers’
at t it u des as m en t ion ed in t h e r epor t abov e cau sed
f eel i n g s o f i n d i g n at i o n an d l ear n i n g d i f f i cu l t i es i n
st u d en t s. I f st u d en t s ar e n o t r esp ect ed an d f u l l y
co n si d e r e d a s h u m a n b e i n g s, t h e y m a y p r e se n t
d i f f i cu l t i es t o see t h em sel v es an d r el at e t o o t h er
p e r s o n s d i f f e r e n t l y. H e n c e , s t u d e n t s c a n n o t b e
r equ ir ed t o r espect ot h er s, for ex am ple, w h en t h ey
ar e not r espect ed or did not lear n t o v alue r espect ,
as w e can only offer t o ot her people w hat w e hav e
ou r selv es( 1 3 ).
I n ot h er r epor t s, st u den t s in dicat e t h at t h e
t eacher’s at t it ude can exert posit ive or negat ive effect s
on st udent s, such as:
“ ...we were having a t heoret ical class wit h a part icular
t eacher, and t wo colleagues were t alking, t he t eacher, who was
already irrit at ed by t he fact t hat t hey had quest ioned her about
som e nam es on her slide and which she could not answer, t ook
t he at t it ude of expulsing t hem , t his creat ed dissat isfact ion in
t he class, as t he st udent s’ t alk was not relat ed t o crit icism against
t he t eacher...”
“ ...we were at t he nursing lab t o learn how t o do a
physical exam , t here were som e colleagues who were already
auxiliaries and t hey st art ed t o use t echnical nam es t hat we didn’t
know , and t o crit icize w hen I asked, t he t eacher called t heir
at t ent ion and said t hat she would t reat everybody at t he lab as if
nobody knew anyt hing and t hat anybody who had t he courage t o
crit icize t he ot hers would have t o explain t he ent ire class cont ent s
and, if t hey didn’t m anage, t hey would be punished, I found t hat
a very good at t it ude, because she didn’t allow t hose who knew
m ore hum iliat e t hose who didn’t ...”
Th e f i r s t s t a t e m e n t r e v e a l s a n e g a t i v e
r ef er en ce, i n v i ew o f d i sr esp ect b et w een t h e t w o
gr oups ( st udent s and t eacher ) . Respect is necessar y
w it h a v iew t o an adequ at e an d ef f icien t t each in
g-lear n in g pr ocess, t h at is, st u den t s n eed t o r espect
t he t eacher and carry out t he proposed act ivit ies, and
t h e t e a c h e r n e e d s t o r e s p e c t t h e s t u d e n t s a n d
u n d er st an d t h ei r m o m en t o f l ear n i n g , el ab o r at i n g
m et h od s t o en cou r ag e t h is p r ocess an d r esp ect in g
t h em as in div idu als u n der for m at ion . I n t h e secon d
t est im ony, on t he ot her hand, t he st udent considered
t h e t each er ’s at t i t u d e as p osi t i v e, b y eq u al i n g al l
st udent s t o t he sam e k now ledge lev el. How ever, t his
im pair s an d ev en dem ot iv at es st u den t s w it h lar ger
t h e o r e t i c a l f o u n d a t i o n s . Te a c h e r s s h o u l d a c t a s
m ediat or s in t he t eaching- lear ning pr ocess, pr oviding
st u d en t s w it h lear n in g m et h od s t h at , in t h is case,
benefit bot h sides. How ever, each t eacher is unique
in his/ her w ay of set t ing up t eaching st r at egies t hat
w i l l e x e r ci se a p o si t i v e o r n e g a t i v e i n f l u e n ce o n
st udent ’s k now ledge acquisit ion in t he classr oom( 14).
St udent s consider ot her r epor t s as beneficial
t o t h e i r l e a r n i n g , w h e n t h e t e a ch e r u n d e r st a n d s
s t u d e n t s ’ l e a r n i n g t i m e a n d e n c o u r a g e s t h e m .
St udent s believ e t hat t he k now ledge t hey hav e can
b e a cce sse d w h e n t e a ch e r s a r e a t l e a st p a t i e n t
enough t o w ait for t hem t o guide t heir t hink ing, ev en
w i t h o u t t h e t each er ’s h el p , an d m an ag e t o r each
conclusions, ev en if par t ially cor r ect( 6), as show n by
t h e follow in g r epor t :
“ ... it was t he first t im e I was doing a urinary cat het er
on a wom an, I was very nervous and afraid of m aking a m ist ake,
t hen she guided m e and gent ly t old m e what was m issing or
giving m e t ips; t hen she went wit h m e t o t alk t o t he pat ient and
t old t he pat ient t o relax, t hat I was a st udent but t hat I knew
w hat I w as doing; I st ar t ed t o open t he packages of st er ile
m at erial and t he t eacher helped m e, when she perceived I was
going t o do som et hing wrong she delicat ely t ook m y arm and put
m e in t he right direct ion, when I finished t he procedure I knew I
hadn’t done everyt hing correct ly, but t he t eacher called m e and
said t h at I h ad t o t ak e an ot h er look at t h e t ech n iqu e, bu t
congrat ulat ed m e, as I did m y best t o do everyt hing right ...”
Th is d em on st r at es t h at t h e t each er sh ou ld
f acilit at e t h e lear n in g pr ocess, cr eat e oppor t u n it ies
f o r l e a r n i n g s i t u a t i o n s , p r o v i d e f o r i n t e n s e a n d
ad eq u at e ex p er ien ces, b e cap ab le of ar ou sin g t h e
m ot iv at ion in st u den t s t o qu est ion an d an in qu ir in g
at t it ude t o seek solut ions and base t heir int ervent ion
on realit y( 11).
St u d en t s ex p ect t each er s t o b e cal m an d
com prehensive, t o underst and t heir m ist akes because
t hey are j ust beginning and t o com m ent on t heir errors,
part icularly t o avoid reoccurrence( 15), as shown by t he
follow ing r epor t :
“ ... t he t eacher asked m e t o writ e a paper, t hat it should
be scient ific, but when I handed it in; she correct ed it and it was
full of observat ions, when I saw it , I t hought , oh dear, t he t eacher
hat ed it , but on t he cont rary, she said it was an excellent paper,
t hat it j ust needed som e m odificat ions and t hat she would help
m e t o get it published, I found her at t it ude very encouraging, as
I didn’t believe m y work could have t his result ...”
Educat or s need t o put lear ner s on t he r ight
t r ack t ow ar ds discov er y an d t h e pr act ice of v alu es
t h r ou g h w h ich ed u cat ion b ecom es m ean in g f u l an d
learners realize t hem selves, which occurs t hrough t he
t each in g- lear n in g pr ocess( 6 )
We also found report s wit h posit ive references
ab ou t seein g t h e t each er as t h e id eal ex am p le of
pr ofessional due t o his/ her act iv it ies:
“ ...I was in t raining at a m at ernit y hospit al, suddenly
t he baby was born and was having a cardiorespirat ory arrest ,
ev er y body got ner v ous, but m y t eacher st ar t ed r eanim at ion
procedures and calm ly asked for m at erial and explained, when we
didn’t know what it was, as if it were norm al care; even t he doct or
becam e calm as a result of her at t it ude, t he baby recovered and
went t o t he nursery, and since t hat day I dream t o be like her....”
I n o r d er t o l ea r n , st u d en t s n eed t o w o r k
cognit ively t o analyze and revise t heir know ledge, so
as t o m ake it really significant and lead t o t he highest
possible com pet ence lev el. The influence ex er t ed by
t h e t each er an d h is/ h er pedagogical in t er v en t ion is
w h a t m a k e s t h e s t u d e n t ’ s a c t i v i t y i m p o r t a n t( 5 ).
H o w e v e r, w h e n t h e d i d a c t i c s i m p o s e d b y s o m e
t eachers does not m ot ivat e learning, st udent s consider
t h is as a n eg at iv e r ef er en ce f or t h eir lear n in g , as
show n below :
“ ... One t eacher always gives class by reading t ext s,
sit t ing down, and she never gives us t he t ext s before, and when
she hands out copies before it ’s no use eit her, because she sit s
dow n and keeps reading, I don’t underst and anyt hing and, w hen
m e and m y colleagues went t o t alk t o her, she said t hat we were
in college and t hat we had t o seek our own knowledge...”
Mon ot on ou s, u n in t er est in g classes an d lack
o f f e e d b a ck h a v e b e e n f r e q u e n t co m p l a i n t s. Ou r
st u d en t s r ead lit t le, w r it e lit t le, p r act ice lit t le an d ,
however, t hey occupy t wo periods per day during four
years as t hey are in a nursing course( 16).
Wit h respect t o facult y m em bers, we obt ained
5 8 r e p o r t s a b o u t t h e i n t e r a ct i o n w i t h t h e g r o u p
cat egory, t en of which ( 20.8% ) cont ained posit ive and
48 ( 79.2% ) negat iv e r efer ences. These r ev ealed t he
f o l l o w i n g a sp e ct s: r e l a t i o n sh i p d i f f i cu l t i e s a m o n g
st udent s - 40 negat iv e r efer ences; som e colleagues’
n e g a t i v e l e a d e r s h i p o f t h e g r o u p - 8 n e g a t i v e
r efer ences; cooper at ion am ong st udent s t o help t he
ot hers - 10 posit ive references.
The fact or of r elat ion sh ip difficu lt ies am on g
st u den t s r eceiv ed a sig n if ican t n u m b er of n eg at iv e
r e f e r e n c e s a c c o r d i n g t o t e a c h e r s ’ p e r c e p t i o n s ,
im plicit ly r ev ealed by t he follow ing r epor t :
“ ...St udent s’ t eaching- learning process is hindered by
t heir difficult ies t o r elat e w it h one anot her , I r em em ber t w o
st u den t s w h o w er e goin g t o m ak e t h eir Cou r se Con clu sion
Monograph t oget her, but t hey argued and t he m onograph was not
handed in in t im e, t he t wo split up and each of t hem had t o find
a new advisor and st art from zero, t his im paired t heir evaluat ion,
and t hey didn’t learn because, t oget her, t hey would have been
able t o do a m uch m ore elaborat e j ob...”
H u m a n b e i n g s w e r e n o t c r e a t e d t o l i v e
alon e. Th ey n eed t o liv e w it h ot h er h u m an bein gs,
but it should be t ak en int o account t hat liv ing t oget her
i n a g r o u p i s c o m p l e x a n d d i f f i c u l t , a s w e a r e
indiv idual beings w it h our ow n opinions, beliefs and
con f lict s.
A n o t h e r f a c t c o n t r i b u t i n g w i t h n e g a t i v e
r e f e r e n ce s t o t h e t e a ch i n g - l e a r n i n g p r o ce ss a r e
st udent s w it h negat iv e leader ship of t he gr oup. This
is clear ly d em on st r at ed b y t h e f ollow in g t each er ’s
t est im on y :
“ . . I h av e a g r o u p t h e Un i v er si t y co n si d er s as a
“ problem ” , and t his is t he case because t he group represent at ive
his colleagues, so t hat t hey could writ e a paper, however, he not
only didn’t pass t he m at erial t o his colleagues, but he also said
he couldn’t ask t hem t o do t hat , as t he explanat ion I had given
w as in su f f icien t t o w r it e t h e paper ; on t h e day t h ey w er e
supposed t o hand in t he paper, as nobody had done it , on his
ad v ice, I b ecam e f u r iou s, an d t h is cau sed t u m u lt am on g
st udent s. During t he st udent s’ argum ent s, I discovered t hat t he
fact t hat had caused t he problem was t hat t he represent at ive had
not passed t he m at erial, so I gave t hem a new deadline and I
called t his st udent for a conversat ion and he t ried by all m eans t o
escape from responsibilit y for what happened, I perceive t hat
t hese at t it udes have been im pairing t eaching since, on t hat day,
I alm ost didn’t m anage t o t each, because I had t o m ake t he
st udent s underst and what had caused t he problem ...”
Accor d in g t o t each er s, p osit iv e r ef er en ces
were sit uat ions in which colleagues collaborat e in t he
at t em pt t o help t he ot her s, as descr ibed her e:
“ ... t here was one st udent who was going t hrough very
serious personal problem s, and she wasn’t able t o at t end class,
so she cam e and t alk t o m e, explaining her sit uat ion and, while
t r y ing t o t alk , she st ar t ed t o cr y com pulsiv ely ; suddenly , a
colleague of hers who was unaware of t he sit uat ion and who
wasn’t even t hat close cam e near and asked t o t ake part in t he
conversat ion, she didn’t say no and, at t hat m om ent , t he colleague
asked m e t o let him help her, and I allowed it , not only did she
m anage t o recover all of t he cont ent s she had lost during t wo
m ont hs, but she also got one of t he highest grades on t he t est ,
and all t hat happened t hanks t o a colleague’s solidarit y....”
FI NAL CONSI DERATI ONS
Ever since t he origins of educat ion, educat ors
an d lear n er s h av e sou g h t t h e t r u e essen ce of t h e
t eaching- lear ning pr ocess. I n pr inciple, t he m eaning
of t he t er m t eaching- lear ning pr ocess seem s sim ple
b u t , act u ally, it is ex t r em ely com p lex , r eq u ir in g a
con st an t sear ch f or t r an sf or m at iv e lear n in g , w h ich
sh ou ld occu r con t in u ou sly an d g r ad u ally t r an sf or m
t he subj ect s inv olv ed.
During t his st udy, we ident ified negat ive and
p o si t i v e a sp e ct s r e l a t e d t o t h e t e a ch i n g - l e a r n i n g
p r o ce ss i n t h e n u r si n g co u r se . I n t h e st u d e n t s’
t e st i m o n i e s, t h e ca t e g o r y o f t e a ch e r ’ s b e h a v i o r
obt ained a significant am ount of negat ive references,
w hich dem onst r at es t hat t eacher s face difficult ies t o
d ea l w i t h st u d en t s’ l a ck o f p r ep a r a t i o n a n d ev en
i m m a t u r i t y d u r i n g t h e i r n u r s i n g c o u r s e . Th i s i s
ev idenced by t he fact t hat st udent s at t r ibut e a lar ge
part of t heir anguish and fears t o t eachers’ behavior.
The t eacher - st udent r elat ion should be seen
as a k ey issue in a pr ocess w her e differ ent per sons,
w it h u n iqu e ex per ien ces, get t oget h er t o ex ch an ge
k n ow led g e in sp ecif ic en v ir on m en t s an d at sp ecif ic
t im es. St u den t s con sider t h at t h e t each in g- lear n in g
p r ocess in t h e classr oom can b e sat isf act or y w h en
high- qualit y hum an relat ions occur. I n t his sense, t hey
highlight t eachers who pay at t ent ion, list en, are honest
and r espect ot her people( 14).
St u den t s st r on gly em ph asized t h at lear n in g
w as im pair ed in sit u at ion s w h en t each er s h in der ed
st u d en t s’ cr ea t i v i t y w h i l e p er f o r m i n g a p a r t i cu l a r
a c t i v i t y, e v i d e n c e d b y t h e t e a c h e r ’s h a r s h a n d
aut hor it ar ian at t it udes.
We found a lar ge num ber of r epor t s r elat ed
t o t he int errupt ion of act ivit ies on t he t eacher’s orders:
r e p l a c i n g o n e m a t e r i a l b y a n o t h e r t o c a r r y o u t
act iv it ies; spillin g a pack age of gau ze on t h e floor ;
forget t ing t he logical sequence while placing a urinary
cat het er; forget t ing t o cut t ape for fixing t he cat het er
d u r i n g v en i p u n ct u r e; w h en t h e t each er i n t er r u p t s
st udent s dur ing a sem inar, ask ing t hem t o r et ur n t o
t heir place; and in alm ost all sit uat ions in w hich t he
t eacher st opped t he act iv it y and per for m ed it in t he
st u den t ’s place, or called t h eir at t en t ion in fr on t of
o t h er p eo p l e an d d i d n o t al l o w t h em t o co n t i n u e
r ealizing t he act iv it y.
Th u s , t e a c h e r s n e e d t o r e f l e c t o n t h e i r
at t it udes, so as t o v alue st udent s as hum an beings
u n d er f o r m at i o n , t o r esp ect t h ei r l i f e ex p er i en ce,
underst and t he m om ent t hey are going t hrough, wit h
a view t o effect ive lear ning( 14)
W i t h r e s p e c t t o t e a c h e r s ’ p e r c e p t i o n o f
posit ive and negat ive aspect s relat ed t o t he t
eaching-l e a r n i n g p r o c e s s , a eaching-l a r g e n u m b e r o f n e g a t i v e
r efer ences w er e at t r ibut ed t o r elat ionship difficult ies
am on g st u d en t s. Esp ecially in t h e n u r sin g cou r se,
in t er act ion bet w een people in a gr ou p is ex t r em ely
im port ant , as nursing st udent s m ust be aware of t he
f a ct t h a t , i n o r d e r t o p e r f o r m t h e i r p r o f e ssi o n a l
act ivit ies adequat ely, t hey will have t o work in groups
const ant ly, w hich r equir es good r elat ionships.
I n t er act ion pr ov ides con dit ion s t o ex ch an ge
e x p e r i e n c e s a n d t r a n s f o r m k n o w l e d g e .
Com m unicat ion is a m eans for t his int eract ion t o t ake
place. Teaching is an im port ant part of t his event when
i t a l l o w s s t u d e n t s t o p a r t i c i p a t e i n t h e i r o w n
d ev elop m en t .
An ot h er cat eg or y t each er s m en t ion ed w it h
leadership of t he group. I n general, in nursing as well
as ot h er ar eas, lead er sh ip is con sid er ed p osit iv ely.
Leaders frequently do not possess form al authorit y, but
ob t ai n t h ei r p ow er t h r ou g h ot h er m ean s, su ch as
influence for ex am ple. They guide follow er s w ho ar e
willing to collaborate( 17). However, when this gift is used
negatively, particularly in the teaching- learning process,
it hinders and, hence, im pairs t he process.
However, st udent s’ cooperat ion t o help ot hers
w a s c o n s i d e r e d a s a p o s i t i v e c a t e g o r y, s i n c e a
s t u d e n t ’ s l e a r n i n g i s n o t o n l y t h e t e a c h e r ’ s
r esp on sib ilit y, b u t t h at of a w h ole g r ou p, inv olv in g
fam ilies, t eacher s, societ y and st udent s.
Te a c h i n g i n t h e h e a l t h a r e a , a n d m o r e
specifically in under gr aduat e nur sing cour ses, should
p r o v i d e f o r k n o w l ed g e a cq u i si t i o n a n d b eh a v i o r a l
ch an g es, alw ay s k eep in g in m in d t h e lin k b et w een
t h eor y an d pr act ice( 1 8 ). Th er efor e, t each er s n eed t o
r eflect on t heir at t it udes, so as t o v alue st udent s as
hum an beings who are being form ed, t o respect t heir
life exper ience and under st and t he m om ent t hey ar e
going t hrough, w it h a view t o effect ive learning( 14).
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