- There are five key changes to explore in the practice of a nurse with a constructivist approach:
1) power relations; 2) content; 3) role of the facilitator; 4) responsibility for learning; and 5) assessment of learning.
- Power relations between the client and the nurse need to be balanced. The nurse is not the expert in the client’s life – the client is the expert.
- The focus is on the learner.
- The nurse as teacher is a facilitator, one who seeks to promote a positive learning environment, beginning by listening carefully to the client’s story of their life including power relations.
- Constructivism seeks to move beyond surface learning to a deeper learning, one where the learner constructs meaning; “the focus shifts from covering content to using the content to develop unique ways of understanding the content and creating meaning.”
- Facilitators need to encourage questions, and encourage learners to use many strategies to locate the content knowledge that is important to them including using the Internet, literature, cultural knowledge and peer informed knowledge.
Role of the Facilitator
- The authority of the nurse/facilitator is challenged by a constructivist approach. The facilitator’s expertise is not negated but rather recedes into the background
- The more active/interactive role is that of the client who is trying to learn about health
The nurse/facilitator encourages the client to be an active learner, and promotes client engagement in an interactive way with the learning materials, media, Internet, and seeking their own knowledge sources.
Responsibility for Learning
- Ideally, nurses are facilitating learning with autonomous, self-directed learners who “assume responsibility for their own learning”
- Nurses must assess the learning needs of the learner and work collaboratively to negotiate an approach to learning that promotes learner responsibility but still guides and facilitates that independence.
Assessment of Learning
- In a constructivist approach the approaches to assessment must be clear.
- For the most part, this assessment is about how well the client understands the knowledge, the implications for safety/health, how supported they are to adopt healthy behaviours, and the resources to follow-up and continue to engage actively in learning to care for themselves and maintain their health.
- Nurses should plan to assess client learning regularly, taking into account the challenges of health literacy, incorporating a holistic analysis of client learning and building on client strengths
Facilitating Client Centred Learning
Point of Care Resources