Teacher-Learner Connection: Nursing Students' Perceptions of Contributory Educational Interactions in Associate Degree Practice Experiences
Worthey, Terri P.
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Session presented on Friday, July 24, 2015: Purpose: The purpose of this interpretive phenomenological study was to enhance understanding of associate of science in nursing (ASN) students' perceptions of the teacher-learner connection and contributory educational interactions within practice experiences. Interpretation of students' lived experiences within senior practice experiences was explored. Additionally, insight into students' perceptions of inviting behaviors and learning partnerships within nursing practice environments was enhanced. Methods: Design: An interpretive phenomenological design was integrated with hermeneutic interpretation to enhance understanding of senior ASN practice experiences. Eleven ASN graduates from an accredited university in the Southeastern United States were included in this study. Data Collection: Qualitative data collected during participant interviews were explored through interpretative phenomenology. Hermeneutic interpretation incorporated researcher reflections, journaling, creating a working image, and the writing and rewriting of text. Conceptual Framework: Invitational theory and the derived application model invitational education (IE) are "built around four assumptions: trust, respect, optimism, and intentionality" (Purkey & Novak, 1996, p. 50). Additionally, levels of functioning, choices, and dimensions are identified as components of human interactions. Purkey (1978, 1988) and colleagues (Purkey & Novak, 1984/1996; Purkey & Strahan, 1995; Stanley & Purkey, 1994) described IT as a collection of assumptions which attempt to explain phenomena. Providing a means of intentionally summoning people to realize their relatively boundless potential in all areas of worthwhile human endeavor, IT addresses the global nature of human existence and opportunity to make life a more exciting, satisfying, and enriching experience (Purkey, 1978; Purkey & Novak, 1984/1996). Invitational theory provides an overarching framework for a variety of programs, policies, places, and processes. Theory of human caring (THC) is applicable to nursing instruction within clinical and classroom settings, and offers a unique framework for exploration of interpersonal relationships and interactions. The concepts of THC can be promoted through educational instruction and research exploration, as well as patient care experiences. According to Watson (2012), the art of transpersonal caring within nursing practice "is a human activity" (p. 81). Transpersonal caring is described as a compassionate connection between beings to assist in an individual's healing (Watson, 2012). However, exploring educational interactions and collaboration between teacher and student was the basis of incorporating transpersonal caring relationships as a guiding framework for this study. Human caring science and transpersonal caring relationship were combined with invitational theory as an educational model to provide a cohesive theoretical framework for this research. Data Analysis: Transcribed data were typed in a Microsoft Word document and downloaded into a data processing software program. The Max Qualitative Data Analysis (MAXQDA) software program assisted in numerically coding paragraphs, adding researcher memos, and highlighting common threads. To enhance study rigor, peer debriefing was implemented during the analytic phase. Upon completion of the first cycle coding analysis of the initial five transcripts, second cycle coding commenced. The first and second coding cycles were then initiated for the remaining six transcripts. Within this study, thematic analysis included a process of narrowing data through hermeneutic interpretation, which consisted of listening to audio-taped interviews, reading and rereading transcribed data, and reflecting on the working image of the lived experience. Thematic analysis produced four primary themes and several subthemes which related to the established research questions, and contributed to the hermeneutic interpretation of ASN senior practice experiences. Additionally, the following research questions were addressed: 1. What is the lived experience of ASN students as they are educated and evaluated by clinical faculty within senior level practice experiences? 2. What contributory educational interactions do ASN students perceive as instrumental to individual transformation to professional nurse? 3. How do students perceive participation within learning partnerships affect experiential learning? 4. What invitational behaviors do ASN students perceive as nurturing the teacher-learner connection during practice experiences? Results: Among the 11 participants, two were male and nine were female, and the average age was 26, with a range of 20 to 42. Previous work experiences were limited among the nurse graduates who were under 30 years of age, and two cited 'full-time student' as their primary work experience. All three participants who were over 30 years of age had previous college degrees and work experiences related to healthcare. Additionally, these participants discussed their increased responsibilities outside the classroom as potential barriers to learning, whereas the younger students described the lack of work experience and decreased confidence as potential barriers. Identified themes reflect the lived experience of ASN students during senior practice experiences. Additionally, participant perceptions of the teacher-learner connection and contributory interactions were uncovered. Enhanced understanding of student perceptions and lived experiences within the experiential learning environment was attained as part of this study. Identified themes included Building Connection, "Suffering through it," Reinforced learning, and "Going through the motions." In addition to the four themes discovered within this study, a total of 12 subthemes were revealed. Within the theme Building Connection, students discussed their desire to interact openly with faculty during practice experiences. Identified subthemes included Inviting, Professional Partnering/Engagement, and Trusting. Many participants mentioned welcoming behaviors and accommodating student learning needs as instrumental in creating a teacher-learner connection. Theme number two, "Suffering through it" was constituted by three subthemes: Discouraging, Contradicting, and Missed learning Opportunities. Although participants reported many encouraging learning encounters during their senior practice experience, most revealed instances when they perceived personality differences among faculty and nursing staff, a lack of teacher engagement, and inconsistencies within the practice experiences diminished individual learning opportunities. During participant interviews, recent nurse graduates discussed how practice experiences reinforced nursing knowledge development. The identified theme Reinforced learning revealed participant perceptions of engaging in active learning through hands-on experience, observing nurses in action, and validation of nursing skills, as well as encouraging "connecting the dots" through critical thinking. Identified subthemes included Role Modeling, Improving Confidence/Validating, and Encouraging Critical Thinking. The theme "Going through the motions" depicted the participants' stories of ineffective learning within senior practice experiences. Students described occasions when nursing staff were unwelcoming, which created uninviting environments and forced students to retreat or avoid interactions. Additionally, some clinical faculty members were described as too harsh and were perceived as demanding perfection. Within the primary theme "Going through the motions," Powerless, Disengaging, and Avoiding subthemes were uncovered. Conclusion: Identification of contributory educational interactions which may support nursing student learning, promote successful transformation to professional practice, and encourage teacher-learner connections was an outcome of this study. Exploring ASN students' perceptions of the senior level practice experience revealed the effects of educational interactions within the clinical environment, identified partnerships which enhance the teacher-learner connection, and enlightened understanding of the human learning experience. The significance of this study brings to light encouraging and discouraging educational interactions within the practice experiences of senior ASN students. Findings within this study further revealed implications related to student learning when faced with inviting and uninviting behaviors during practice experiences. The discovery of students' perceptions of contributory educational interactions advances nursing science, and provides a foundation for future research. Consequently, faculty, preceptors, and nursing staff may utilize findings from this research to improve learning outcomes, and enhance practice experiences of future nursing students. Understanding student perceptions of the essential connections within the clinical learning environment may augment student success and individual transformation from nursing student to professional registered nurse. Additionally, as faculty and preceptors become enlightened about students' perceptions of disconnections within the learning environment, the essential connections between classroom content and practice application, inviting behaviors and student learning, and the teacher-learner relationship may be nurtured. Recommendations for nursing education include encouraging nursing faculty to develop effective teaching strategies to address relationship building within the practice experience and beyond. Understanding a nursing student's need to relate in a positive manner with individual instructors, preceptors, and nursing staff will enhance experiential learning and influence student transformation. Contributions from this research include findings which increase awareness of effective and ineffective learning connections within the clinical environment. Additionally, research findings provide support for educational programs designed to enlighten nursing staff about the positive and negative educational interactions conveyed to nursing students. Incorporating invitational education principles along with transpersonal caring relationship concepts, nursing practice may begin to address inadequacies within the clinical learning environment and encourage professional partnering between nursing staff and student nurses. Strengthening the transformation from student nurse to graduate nurse and ultimately to professional registered nurse should be considered the responsibility of educators, nursing staff, and healthcare administrators. Future research should continue to examine student perceptions of effective learning opportunities, provide data on how to foster contributory educational interactions, and increase understanding of essential learning connections. In addition to the aforementioned focus areas of inquiry, nurse researchers should continue to explore faculty and preceptor behaviors which enhance learning and augment the student nurse transformation to professional registered nurse. It would also be interesting to discover faculty, nursing staff, and preceptor perceptions of contributory educational interactions within practice experiences.