In nurse education, a variety of teaching styles are used, ranging from didactic lectures given to large numbers of people to teaching in small groups. Nurse educators are often challenged to find methods that engage students with enthusiasm to understand concepts (Aruna et al, 2014). Mills and Alexander (2013) identified that, in small group teaching, dialogue and collaboration between participants are fundamental to learning. Hughes and Quinn (2013) postulate that one way to achieve these is by encouraging students to participate in group discussions during their learning. This paper will examine the benefits of using seminars as a teaching method in undergraduate nurse education.
Students need to understand and learn. One way to achieve this is to use active teaching methods such as seminars. There are many benefits to using these in undergraduate nursing programmes. Quinn (2000) suggested that a key aim of seminars is to encourage students to develop a level of critical thinking skills. He argued that one way of achieving this is to encourage them to contribute actively to debate and dialogue. Spruijt et al (2013) maintained that seminars allow students to participate in discussions under the guidance of an expert, and thereby become active participants in their own learning. Worth (2013) states that seminars provide a variety of learning opportunities.
The author was the lead for a learning unit entitled person-centred practice (PCP), which is delivered in the first semester of the BSc Nursing (Adult) course. This unit is planned so that students form an understanding of the key contents by engaging in a variety of student-centred activities such as group work and online learning. Through these activities, students are helped to become informed, self-motivated and curious learners.
The elements, content, teaching strategies, required outcomes and learning activities are all aligned, which supports the concept of constructive alignment (Biggs, 1996). Constructive alignment is the supporting concept behind the requirements for programme specification, affirmations of learning outcomes and assessment criteria (Biggs and Tang, 2011). There are two basic concepts behind constructive alignment: constructive alignment is a principle used for devising teaching and learning activities, as well as assessment tasks, that clearly address the proposed learning outcomes in a way not typically achieved in traditional lectures and tutorials, classes and examinations; and, second, the alignment signifies what the lecturer does, for example developing the learning environment to support activities appropriate to achieving the learning outcomes.
An example of this is when a lecturer makes a conscious alignment between the planned learning activities and the outcomes, eg giving students clearly specified goals with well-devised learning activities that are appropriate for the task. In other words, the lecturer develops well-devised lesson plans. To ensure the author's lesson plan was correct, some of his peers reviewed it for him.
Reflective discussion
A key element of the learning unit is that students understand the 6Cs incorporated into PCP. These 6Cs are the values on which nursing care is based: care; communication; courage; competence; commitment; and compassion (NHS England, 2016). It is expected that students have a theoretical understanding of the 6Cs before implementing them in practice under the supervision of their mentor.
Although the author was an experienced lecturer, teaching a unit that consisted mainly of seminars was quite new to him. By reading the literature regarding small group teaching and seminars and having discussions with colleagues about how students learn during seminars, he gained an understanding of how to develop lesson plans for a seminar approach to learning.
The Higher Education Academy (Mills and Alexander, 2013) contends that small group teaching is not defined by numbers. The 120 students undertaking this unit were initially divided into eight groups, each with 15 students. Each group was then divided into two smaller groups of 7-8 people. The author's main goal was to assist students to develop their academic, innovative and practical potential while encouraging their personal development. Working collaboratively in learning allowed students to gain confidence in developing their skills to work, both as part of a group and independently. Smaller groups helped to support the student-centred activities used, allowing participants to share ideas, and gave the author an opportunity to appraise his teaching by being made aware of any misunderstanding on the students' part.
Neary and Winn (2009) suggested that student-led discussions are a valuable way to participate actively in learning, starting with its theoretical grounding of students being co-producers of learning. During the seminars, students were required to participate, lead and elaborate in discussions on the theoretical aspects of patient-centred practice. Therefore, before any of the 2-hour seminars began, it was necessary to ensure students already had knowledge of what would be discussed. To achieve this, a range of lectures covering topics such as ‘what is PCP?’, the history of the 6Cs, respect, dignity, humanity, and students' personal and professional boundaries in delivering safe and effective care were delivered.
Group discussion can play a valuable role in nurse education. Therefore, at the beginning of each 2-hour seminar and to help to create an initial discussion within the group, some thought-provoking questions were asked, such as: what are the different types of communication? Why is communication necessary in PCP? This lasted about 10–15 minutes depending on the C under discussion. As the groups were new, this allowed students to become more relaxed with each other. It also meant knowledge could be shared and, as some students had previous healthcare experience, this helped to create further discussion. Learning through discussion helps students to develop ideas from each other, which supports them to develop their own thinking. Discussion can also develop the skills of listening, presenting ideas, persuading and working as part of a team (Jacques, 2003).
Following this, each small group was given 1 hour and 15 minutes to develop a digital poster presentation regarding the C under discussion, eg communication. Part of the assessment process for this unit was that each small group developed a digital poster on one of the 6Cs and submitted it online. This method of assessment is popular with students for many reasons (McDowell, 1995). They find it fun to do, it promotes tangible ownership of their work, and it gives them valuable experience for future presentations (Wimpfheimer, 2004). Tanner and Chapman (2012) suggested that students creating a poster is an example of a hands-on approach to learning. Lynch et al (2012) postulated that it encourages a deep level of learning that can be assessed. During the seminars, students were given a brief outline of what may be included in their poster, eg different types of communication, why communication is important, and the barriers to communication in PCP.
This part of the seminar was very much student led. This student-led approach allowed group members to demonstrate their problem-solving skills. Barkley (2010) identified that students who are immersed in the academic environment use higher order thinking skills such as problem-solving techniques.
As nurse education has become more advanced in its use of technology, it is vital that students interact with technology during the seminars. Therefore, students used their laptop computers to research topics and develop their digital posters. Bainbridge (2014) examined how technology in learning can create discussions and enhance learning.
Attard et al (2014) suggested that student-centred activities aim to promote learning in communication with lecturers and other students, so this approach takes students seriously as active participants in their own learning. To enhance student-centred learning, it was suggested that each group identify roles that each member could do, eg team leader, researchers for different areas or poster designer. An awareness of research in the first year of university is important; nursing practice should always be underpinned by the best available evidence, so it is essential that nurses are able to understand the research process (Bowrey and Thompson, 2014). Furthermore, investors in nurse education such as the Department of Health (2006) support this view by noting that research skills should be part of preregistration education provision.
The author walking around the classroom and asking each group some questions about what they were doing, and why, helped facilitate the process of developing digital posters and encouraged collaborative and peer learning. Formative assessment also occurred at this stage. Students were given formative feedback on their progress and were asked to think about ways in which they could develop the information they had and how they would present it clearly in their poster presentation. This provided a form of experiential learning, reflective of a model by Kolb (1984). Students appeared to enjoy this approach. They became more relaxed with the learning process while remaining determined to develop their skills in researching information and using technology to enhance learning.
After 1 hour and 15 minutes, the students were asked to present their poster to their peers and lecturer. All students in each small group of 7-8 were asked to contribute to the presentation, which was delivered to the 15 students that made up their seminar group. This provided a forum for students to develop their social skills and confidence in the presence of others (Hughes and Quinn, 2013). Although nobody refused to take part in the presentation of the poster, students were initially nervous, but this became less so in subsequent seminars and their ability to present to others and to create a discussion became very apparent.
Following their presentation, each small group also gave feedback to their seminar group. This peer feedback was positive and the small groups thought there were no errors in each other's presentations. However, the lecturer provided constructive feedback, which allowed students to reflect on their own learning. Reflection is an essential process of growth and change, and should form the basis of formative, progressive growth in a particular area (Horton-Deutsch and Sherwood, 2008). For reflection to be effective, learners need courage and a readiness to accept and act on feedback (Bulman et al, 2012).
The end-of-unit student satisfaction evaluation was 100%, and the feedback from the external examiner was very favourable. Evaluating his own practice was important for the author's personal growth, as this is used to develop teaching, facilitation and feedback skills, which are essential to maintaining a high-quality learning experience for students.
Conclusion and recommendations
Using seminars as a teaching method helps to ensure undergraduates understand and can learn what they need to know by using a range of approaches to support them in their personal and academic growth. Seminars help students to develop their self-confidence and in areas including discussion, the use of technology, groupwork, independent learning, student-led learning, problem-solving and reflection techniques. Students appeared to enjoy the learning techniques used in the seminars and their evaluation of the unit was excellent.
It is important that lecturers use feedback to develop teaching, facilitation and feedback skills. Continuing with lifelong learning opportunities is essential. To develop this further at a personal level and to further engage students in the future, more interactive, technology-enhanced learning would be useful. This could include a system to synchronise laptops in the classroom, allowing nurse education to become more engaging through interactive multimedia presentations.