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ePortfolio & learning styles in
          Nursing Education




Kirsten Nielsen, PhD. Stud., MSc Nursing, Niels H. Helms, Director Knowledgelab,
    MA (History & Chinese) & Birthe D. Pedersen, Associate professor, PhD., MSc
                           Nursing, exam.art. (Philosophy)
Background
•ePortfolio at the School
of Nursing, Campus
Holstebro since 2007
•A third of the students
did not use the
ePortfolio

•Why not?                                       CAMPUS HOLSTEBRO




              Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk   2
Answers
•I don´t need to write
down my reflections. I
reflect, when I talk to
my preceptor
•It is timeconsuming. I
want to use my time
here nursing
•I use it only for the
sake of my preceptor


              Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk   3
ACTIVIST STYLE                                                                 REFLECTOR STYLE




PRAGMATIC STYLE                                                                THEORIST STYLE




                               AESTHETIC       MORAL          COGNITIVE
                               EXPRESSIVE      PRACTICAL      INSTRUMENTAL
                               REASON          REASON         REASON

(Honey & Mumford 2000)        (Scheel 2008, Habermas 1981)
                    Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk              4
Aim & Research Questions
To investigate the learning potentials of an ePortfolio
  designed to facilitate four learning styles in the clinical
  part of the Nursing Education

•   How is ePortfolio used?
•   Does ePortfolio support learning of nursing?
•   Does ePortfolio support reflection?
•   How can learning styles be discussed in relation to
    ePortfolio?



                 Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk   5
Method
•The study is qualitative

•A phenomenological-
hermeneutic design

•Inspired by the french
philosopher Paul Ricoeur

                                                                Paul Ricoeur
                                                                1913 - 2005



               Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk   6
Setting & participants
•Clinical course in hospitals
& a nursing home

•Learning style indicator by
www.@ventures.dk /
www.evidencenter.dk

•4 Subgroups

• 11 students randomly
chosen

                Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk   7
Generation of Data
Participant observations                  Each Student is observed for one day at the
                                          begining & in the end of the course

Narrative interview                       What did you experience caring for patients
                                          today?

Portfolio documents from the              The student uses the ePortfolio
students ePortfolio

Narrative interview                       What did you learn from using ePortfolio?




                      Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk   8
Use of ePortfolio
• Planning how to achieve the objects of the Course
• Differentiated Guidance
• Formative Evaluation
   • Bondys Criteria for Clinical Evaluation
   • Students & preceptors
• Diary
• Reflection & critical thinking
• Cooperation
• An outlet for feelings
• Uncover need of learning

               Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk   9
Ændres så udsagnene bliver
                                                                            tydelige et ad gangen.


Barriers to use ePortfolio
”I don´t have the need of
writing”
”I´m used to think about it
by myself … I´m not used to
talk about it”
 ”What if I write something                                ”I feel taken captive
wrong!”                                                    by my actions … it
”I learn much more from                                    cannot be undone
                                                           … it gives me more
dialogue with the nurses”
                                                           to fight for next
”I´m just not good at it …”                                day”
             Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk                            10
Hermansens Theory of Relearning
                                            N
                                            o
  Exuberance                                w

   Toil                                                                             Social context


Reflec-
tion


                                                                         Individual life projects
Habitus                                                                  of existence
          Feedback              Feed forward
                                                                                  (Hermansen 2005)

               Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk                      11
ePortfolio supports Learning of Nursing
A patient is displeased with                      Behavioral & attitudinal
his situation and blame the                       change
student. She writes about
her feelings & concludes:
”Though it´s been a bad
day, I havn´t put on an
angry face … I think I´ve
been a professional
today…”


                Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk   12
ePortfolio supports Learning of Nursing
… her oxygen tube was placed wrong                      Writing about experience
and oxygen saturation was 88 %, so I
placed it correctly and after some                      and theory lead to active
time the saturation was 91 %. She                       knowledge & more skilled
was feeling much better, she said,                      nursing
and I observed that she was much
more conscious …
As one of the first organs the brain
will be influenced by low oxygen
saturation. The patient will be sleepy,
dizzy … speech wil be indistinct …
and the patient will lose
consciousness




                      Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk   13
Learn to advocate the patient
A student suggests that a                           Morning meeting
patient should be helped
into the toilet at night but
cannot argue for it. She
writes in ePortfolio about it.
Afterwards she can give
reasons for her suggestion
and takes action to
implement it




                 Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk   14
ePortfolio supports Reflection
Patients with different pulmonary diseases have
  bronchi stricture … which cause difficult
  expiration. This lead to increased pressure in
  the lungs … and emphysema … this reduces …
  the gas exchange …
Procedure: I´ll inform the patient …to generate a
  valid result it is important, that the patient had
  no bronchi dilatation medicine … the best result
  is when the patient stands … but in this case he
  must sit down, because he is unsteady on his
  feet
              Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk   15
Self-evaluation & need for learning
1. [I am] Supervised and assisted [because]
There are still situations where I am in doubt, and I ask
   rather than do something wrong.
I can interact with the patients … mostly … it is difficult,
   when what people say with words is different from their
   body language.

2. I have achieved my object: to gain more knowledge
   about wound care, … I still lack experience in assessing
   what dressings are suitable for different wounds.


                Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk   16
Use of ePortfolio
•½ - 7 hours/week                                           Consumption of
  • 6 students used ePortfolio at                           Time
    home
  • 3 students used ePortfolio in
    the ward
  • 2 students used ePortfolio
    both at home & in the ward
•No one prioritized
ePortfolio at the expense
of Nursing the patients

               Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk   17
To be continued …

THANK YOU VERY MUCH FOR
YOUR ATTENTION 

             Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk   18

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ePortfolio & learning styles in Nursing Education

  • 1. ePortfolio & learning styles in Nursing Education Kirsten Nielsen, PhD. Stud., MSc Nursing, Niels H. Helms, Director Knowledgelab, MA (History & Chinese) & Birthe D. Pedersen, Associate professor, PhD., MSc Nursing, exam.art. (Philosophy)
  • 2. Background •ePortfolio at the School of Nursing, Campus Holstebro since 2007 •A third of the students did not use the ePortfolio •Why not? CAMPUS HOLSTEBRO Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk 2
  • 3. Answers •I don´t need to write down my reflections. I reflect, when I talk to my preceptor •It is timeconsuming. I want to use my time here nursing •I use it only for the sake of my preceptor Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk 3
  • 4. ACTIVIST STYLE REFLECTOR STYLE PRAGMATIC STYLE THEORIST STYLE AESTHETIC MORAL COGNITIVE EXPRESSIVE PRACTICAL INSTRUMENTAL REASON REASON REASON (Honey & Mumford 2000) (Scheel 2008, Habermas 1981) Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk 4
  • 5. Aim & Research Questions To investigate the learning potentials of an ePortfolio designed to facilitate four learning styles in the clinical part of the Nursing Education • How is ePortfolio used? • Does ePortfolio support learning of nursing? • Does ePortfolio support reflection? • How can learning styles be discussed in relation to ePortfolio? Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk 5
  • 6. Method •The study is qualitative •A phenomenological- hermeneutic design •Inspired by the french philosopher Paul Ricoeur Paul Ricoeur 1913 - 2005 Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk 6
  • 7. Setting & participants •Clinical course in hospitals & a nursing home •Learning style indicator by www.@ventures.dk / www.evidencenter.dk •4 Subgroups • 11 students randomly chosen Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk 7
  • 8. Generation of Data Participant observations Each Student is observed for one day at the begining & in the end of the course Narrative interview What did you experience caring for patients today? Portfolio documents from the The student uses the ePortfolio students ePortfolio Narrative interview What did you learn from using ePortfolio? Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk 8
  • 9. Use of ePortfolio • Planning how to achieve the objects of the Course • Differentiated Guidance • Formative Evaluation • Bondys Criteria for Clinical Evaluation • Students & preceptors • Diary • Reflection & critical thinking • Cooperation • An outlet for feelings • Uncover need of learning Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk 9
  • 10. Ændres så udsagnene bliver tydelige et ad gangen. Barriers to use ePortfolio ”I don´t have the need of writing” ”I´m used to think about it by myself … I´m not used to talk about it” ”What if I write something ”I feel taken captive wrong!” by my actions … it ”I learn much more from cannot be undone … it gives me more dialogue with the nurses” to fight for next ”I´m just not good at it …” day” Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk 10
  • 11. Hermansens Theory of Relearning N o Exuberance w Toil Social context Reflec- tion Individual life projects Habitus of existence Feedback Feed forward (Hermansen 2005) Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk 11
  • 12. ePortfolio supports Learning of Nursing A patient is displeased with Behavioral & attitudinal his situation and blame the change student. She writes about her feelings & concludes: ”Though it´s been a bad day, I havn´t put on an angry face … I think I´ve been a professional today…” Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk 12
  • 13. ePortfolio supports Learning of Nursing … her oxygen tube was placed wrong Writing about experience and oxygen saturation was 88 %, so I placed it correctly and after some and theory lead to active time the saturation was 91 %. She knowledge & more skilled was feeling much better, she said, nursing and I observed that she was much more conscious … As one of the first organs the brain will be influenced by low oxygen saturation. The patient will be sleepy, dizzy … speech wil be indistinct … and the patient will lose consciousness Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk 13
  • 14. Learn to advocate the patient A student suggests that a Morning meeting patient should be helped into the toilet at night but cannot argue for it. She writes in ePortfolio about it. Afterwards she can give reasons for her suggestion and takes action to implement it Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk 14
  • 15. ePortfolio supports Reflection Patients with different pulmonary diseases have bronchi stricture … which cause difficult expiration. This lead to increased pressure in the lungs … and emphysema … this reduces … the gas exchange … Procedure: I´ll inform the patient …to generate a valid result it is important, that the patient had no bronchi dilatation medicine … the best result is when the patient stands … but in this case he must sit down, because he is unsteady on his feet Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk 15
  • 16. Self-evaluation & need for learning 1. [I am] Supervised and assisted [because] There are still situations where I am in doubt, and I ask rather than do something wrong. I can interact with the patients … mostly … it is difficult, when what people say with words is different from their body language. 2. I have achieved my object: to gain more knowledge about wound care, … I still lack experience in assessing what dressings are suitable for different wounds. Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk 16
  • 17. Use of ePortfolio •½ - 7 hours/week Consumption of • 6 students used ePortfolio at Time home • 3 students used ePortfolio in the ward • 2 students used ePortfolio both at home & in the ward •No one prioritized ePortfolio at the expense of Nursing the patients Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk 17
  • 18. To be continued … THANK YOU VERY MUCH FOR YOUR ATTENTION  Contact Kirsten Nielsen, kirn@viauc.dk / kinielsen@health.sdu.dk 18