Pimsupa Chandanasotthi too19@hotmail.com Nongnutch Chowsilpa nongnutch@msn.com Faculty of Nursing,
Nakhon Pathom Rajabhat University, Thailand
Abstract
Project-based learning (PBL) and service learning (SL) are innovative approaches to enhance nursing students’ competencies for contributing to the social needs of society in the 21st century. PBL is a student-driven, teacher-facilitated approach to learning, while SL is an experiential approach where the students work to meet the needs of the society and the community to complete academic requirements.
The purpose of this study is to describe the successful PBL and SL experiences of undergraduate nursing students. Sixty-three first year nursing students were divided into 10 groups in the Give for Life subject. In the summer semester each group created and undertook a project which focused on the needs of the local community. For example: students were involved in projects with handicapped children; aging people in homecare and the community;
patients in hospital; and a recycling project for the environment.
The students improved their communication and collaboration competencies amongst their groups, the hospital and the institute in the community. They also learned to be self-reliant through critical thinking, planning, and organizing.
The reflections of students’ experiences in each project revealed that they gained a better understanding in physical and mental health, and functional needs of children, aged people, and patients.
Moreover, these competencies of creativity, communication, collaboration and compassion through project-based action and service learning can provide knowledge from real world experiences, and also improve the volunteer spirit of nursing students which is needed in the 21st century.
Introduction
Nurses of the 21st century need to be prepared for competency to meet the needs of society which is changing rapidly. Nursing academic institutes must be responsible for preparing the next generation of nurses in the real-world and assist them to become problems solvers, better researchers, and higher-order thinkers.
71 Project-based learning (PBL) is a learning method based on constructivism which was proposed by John Dewey (Douglas and Stack, 2010). PBL is a key strategy for creating thinkers and learners in real-life situations. Nurses also work in a multicultural society with differences in race, ethnicity, religion, historical experiences, gender, sexual orientation, age, disability, socioeconomic status, geographical location, language barriers, and low literacy.
Service-learning (SL) is defined as “a structured learning experience that combines community service with explicit learning objectives, preparation, and reflection” (Seifer, 1998, p.274). SL is also recognized as valuable instruction involving experiential learning, reflection, and reciprocal learning where the student works to meet the needs of the community while meeting academic requirements (Brown & Schmidt, 2016; Cashman, Sarena, & Seifer, 2008). Research reveals that students’ learning is enhanced through service learning where students demonstrate improved critical thinking and problem solving abilities following a service learning experience (Stallwood & Groh, 2011; Nokes, Nickitas, Kieda, & Neville, 2005).
Moreover, a student’s attitudes and perceptions have been positively altered by increasing caring, leadership, and professionalism heightening sensitivity to cultural diversity (Foli, Braswell, Kirkpatrick, & Lim, 2014; Amerson, 2010). PBL and SL enhance nursing students’
competency for contributing to social needs. PBL is a student-driven, teacher-facilitated approach to learning, while SL is an experiential approach where the students work to meet the needs of the society and the community, to complete academic requirements.
SL is more than volunteerism because it links academic course work with service to the community. Community is defined in a variety of settings, including community agencies, daycare centers (pediatric and adult), schools, public health agencies, clinics and hospitals.
Faculty, academic institutions, community organizations, and community members gain benefits from SL. Faculty reported stronger relationships between students and faculty and also increase satisfaction with the quality of SL (Champagne, 2006). In addition, SL has the potential to improve clients’ perceptions of quality of care and behavior changes that improved health care outcomes (Reising, Allen, & Hall, 2006).
Research question
How does the project-based learning and service learning program, Give for Live, strengthen the competencies of 21st century nursing students?
Competency is described as a set of capabilities, skills, aptitudes, expertise, and
experiences. The nursing education paradigm in the 21st century shifts from caring for patients to caring for people. The paradigm shifts from diseased-based to promoting a culture of health with multiple new roles for registered nurses working with people not patients.
Therefore, the baccalaureate nursing students require more competencies which increase in complexity from 1st year to 4th year of the nursing program. The level of competencies include:
recognizing the relationship of health and illness; differentiating developmental and psychological skills; developing a collaborative plan of care; acting as an advocate for patients, families and the population; choosing effective communication techniques; synthesizing the scientific process; integrating technologies; collaborating with a community partner and interprofessional team; evaluating population health interventions; incorporating knowledge;
and applying the principle of research in a practice setting. (Bouchaud, Brown, & Swan, 2017).
72 Objective
The purpose of this study is to describe experiences, opinions, and the competencies of undergraduate nursing students using project-based learning and service learning experiences.
Methodology
This qualitative study was conducted using descriptive phenomenology. Sixty-three first year nursing students were divided independently into 10 groups in the Give for Life subject. During the summer semester within 2 months each group created and carried out a project as project leader for the whole class, which focused on the needs of the local community. Subjects for projects included: handicapped children; aging people in homecare and the community;
patients in hospital; recycling for the environment; collecting money for charity projects for elderly people at homecare and for handicapped children; cleaning a temple nearby university as volunteers. The research aim and information was explained to participating students. Self-reflections, project evaluations, and observations were collected during the project.
The main part of this report records students’ reflections on each project according to the activities they performed, the results, and reflections on the impact of the research on themselves. The data was analyzed by content analysis.
Results
Nursing student characteristics: 93.65% of participants were female, average age was 19.51 years old, 98.4% used to be volunteers during attendance at high schools.
The nursing students’ self-reflection revealed that they improved their communication, compassion and collaboration competencies not only within their group, but also when with elderly people at homecare, and with the disabled children institute in the community.
Communication
The communication with elderly people was improved. Nursing students felt more sympathetic and more comfortable with elderly disabled people. Students created activities that made elderly people laugh and join activities such as singing and playing games. They reflected that they feel as though these elderly people were their grandmother and they felt happy to take care of them and wanted them to feel happy too.
‘I feel very happy to talk with the elderly people because I feel that they are my grandparents and I want to make them happy.’
(Student no. 6).
‘… the blessing from elderly people to us after activities make me warm and proud to be the giver and the receiver happiness as the same time…’
(Student no. 39).
73 Students also communicated with disabled children by playing, singing and dancing. They felt happy to take care of the disabled children and gave them some gifts from their own money.
‘I am so glad to do this project for the disable children here. They need love and care from us. My money that bought gifts for them make me happier than buy gifts for myself.
(Student no. 13).
Compassion
During the active learning via the activities of the projects, students had opportunities to listen and talk with elderly people and disabled children. These experiences touched their hearts and linked them to their families.
‘I will not leave my grandparent to be lonely like this. If I have a chance I will be back here to make the elderly people happy.’
(Student no. 7).
‘I cried and missed my grandmother at my hometown when I saw these elderly people.
I think they must be lonely and miss their children too.’
(Student no. 3).
Collaboration
The necessity of team work amongst students developed while creating the projects. They found that the project could not be completed without collaboration amongst themselves, institutes in the community, and teachers who were facilitators and consultants for their projects.
‘Our project of recycle waste needs co-operation from our class, so we could not finish the project by only 7 of us, then the money from selling recycle waste we will give to elderly project.’
(Student no. 18).
‘I tried very hard to make the project success by contacting the officer of elderly homecare for asking to do activities. I’m so proud of myself and team. However, the teacher always gave me useful suggestion when I needed.’
(Student no. 47).
Creativity
They also learned to be self-reliant through critical thinking, planning, and organizing the projects appropriately with each group of people. They felt confident to work with people in different societies.
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‘In the beginning, I felt very shy to ask people at the evening market in front of our university for donation money for our project, then I play guitar and sing with my friends. It makes me happy and people were interested and gave more donation.’
(Student no. 9).
‘When we create the games for elderly people, we need to concern about the safety because falling is very dangerous for them.’
(Student no. 50).
Conclusion
The reflections of students’ experiences in each project revealed that they gained a better understanding of physical and mental health, and functional needs of children, elderly people, and patients. Moreover, these competencies of creativity, communication, compassion and collaboration through project-based action and service learning can provide knowledge from real world experiences. A volunteer spirit is needed amongst nursing students as a model for volunteer competency development in the 21st century.
Figure 1: The model of Give for Live: A volunteer competencies development program for nursing students in the 21st century
75 References
Amerson, R. (2010). The impact of service learning on cultural competence. Nursing Education Perspective, 31, 19-22.
Bouchaud, M., Brown, D., & Swan, B. A. (2017). Creating a new education paradigm to prepare nurses for 21st century. Journal of Nursing Education and Practice, 7(11), 27-35.
Retrieved on April 13, 2018 from
http://www.sciedu.ca/journal/index.php/jnep/article/viewFile/11279/7064
Brown, J. M., & Schmidt, N.A. (2016). Service learning in undergraduate nursing education:
Where is the reflection? Journal of Professional Nursing, 10, 48-53.
Cashman, S., Sarena, D., & Saifer, D. (2008). Service-learning: An integration part of undergraduate public health. American Journal of Nursing Education Scholarship, 7(1), 1-26.
Douglas, J. S., & Stack, S. F. (210). Teacher, leaders, and school: Essays by John Dewey.
Carbondale: Southern Illinois University.
Foli, K.J., Braswell, M. M., Kirkpatric, J., & Lim, E. (2014). Development of leadership behaviors in undergraduate nursing students: A service approach. Nursing Education Perspectives, 35, 76-82.
Nokes, K.M., Nickitas, D. M., Kieda, R. & Neville, S. (2005). Does service-learning increase cultural competency, critical thinking, and civic engagement? Journal of Nursing Education, 44, 65-70.
Resing, D. L., Allen, P. N., & Hall, S. G. (2006). Student and community outcomes in service learning: Part 2-community outcomes. Journal of Nursing Education, 45, 516-518.
Schmidt, N. A. & Brown, J. M. (2016). Service learning in undergraduate nursing education:
Strategies to facilitate meaningful reflection. Journal of Professional Nursing, 32(2), 100-106.
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