The contemporary healthcare environment is an authentic, demanding, challenging and ever-changing environment that requires learners to possess good self skills when they need to engage in meaningful, critical discourse in order to solve authentic problems. However, nurse educators assume that learners already have well-developed self skills at the commencement of their nursing training and as a result do not explicitly teach and develop such skills in the learners.
The objectives of this research were to explore and describe nurse educators’ views on how learners’ self skills can be developed within an authentic learning (AL) environment, and to formulate recommendations based on the findings.
A qualitative and contextual research design was used to seek rich, in-depth data from 20 nurse educators who were purposively sampled. Semi-structured individual interviews were conducted, and the data were analysed using Miles, Huberman and Saldaña method.
The three themes that emerged were that nurse educators should (1) ensure an AL environment that promotes self skills, (2) engage learners in activities that will consciously evoke authentic self and (3) evaluate the developed self skills and metacognition.
By developing good self skills, learners should be able to deliver quality patient care, find solutions to complex problems and handle cognitive complexity and authentic conditions whilst creating their own identity.
The current healthcare environment is a demanding, challenging and ever-changing interplay of inevitable key changes that take place nationally and globally on political, economic, social, demographic, competitive and technological levels. These changes call for nursing education institutions to produce highly skilled healthcare graduates who are able to meet the unrelenting demands of the unpredictable healthcare environment of the 21st century. To succeed, it is essential that the training develops crucial self skills that will assist graduates to continually adapt to the healthcare uncertainties (Dyson
An AL environment is a complex, challenging real-life or virtual setting in which learners engage in activities that mimic the real professional world where they are expected to simulate their acquired knowledge (Vereijken et al.
Nurse educators need to take cognisance that such AL activities can be extremely challenging and frustrating for novice learners, and as a result, the learners often face difficulty in acquiring self skills as well as higher-order thinking skills on their own without scaffolding. Irrespective of the challenges of AL, nurse educators should aspire to develop these skills by immersing learners in real-world, ill-defined, challenging, complex problems, and authentic assessments (Cañas, Reiska & Möllits
As a learner-centred approach, AL is anchored in philosophical and theoretical foundations that include participative, experiential, andragogical, motivational, humanistic, activity-based and constructivist, as well as situation- and problem-based learning approaches. By the very nature of the authentic problems within these foundations, learners are compelled to interact, communicate and collaborate meaningfully and effectively with many more-abled individuals such as global experts, communities of practice, educators, peers and real communities (Koretsky et al.
The self skills are the personal abilities that learners develop and use when engaged with more-abled others within an AL environment, and they include self-awareness, self-dialogue, self-inquiry, self-reflection and metacognition. The first question that arises in this context is who is self within such an environment? Priest defined the self as ‘an individual that is conscious of the individual that it is whilst being conscious that it is the individual it is conscious of’ (
The purpose of higher education is to produce a well-rounded graduate who is a future change agent (Frank & Stanszus
The aim of this research is to provide the reader with a deeper understanding of how nurse educators can develop learners’ self skills within an AL environment.
The study explored and described nurse educators’ views on the development of learners’ self skills within an AL environment with a view to formulate recommendations based on the findings.
The research design was qualitative and contextual in nature, and was used to seek rich, in-depth data by exploring and describing the views of nurse educators (Gray, Grove & Sutherland
The study was conducted in the department of nursing at the University of Johannesburg, where the researcher taught second-year undergraduate learners, supervised master’s students and worked with participants as colleagues. At the time of the study, the department offered the following programmes: a 4-year undergraduate bachelor’s degree, a 3-year post-basic bachelor’s degree, post-basic diplomas in nursing science such as nursing education, nursing administration, community, critical care, advanced midwifery and primary health, as well as master’s and doctoral degrees. The department thus catered for undergraduate, post-basic and postgraduate learners.
The study was descriptive and not interpretive in nature, and thus, self-reflection was maintained through the use of a reflective diary from the commencement of the research once the phenomenon of interest was chosen and was kept throughout the research process. This diary was shared with two colleagues who assisted with peer debriefing where meaningful dialogues were held with them. These dialogues assisted the researcher in the process of disengaging self by providing provocative discussions on the research, collected data and findings using the researcher’s reflective diary. Neither of these two colleagues took part in nor assisted with the interviews, thus, were not involved in the research. During the interviews, the researcher did not bring any of her preconceived ideas as one question was posed to all participants, and only probed and paraphrased their responses as well as sought understanding through asking a question: ‘What does … mean?’ Therefore, no questions relating to the researcher’s own experiences, knowledge or preconceived ideas were posed (Kim et al.
A sample of 17 female and three male nurse educators consented to participate in the study. Consequently, rich, in-depth data were collected until no new information emerged (Gray et al.
The sample: nurse educators’ demographic information.
Variable | Number |
---|---|
Total participants | 20 |
Teaching experience (years) | 3–12 |
Master’s | 15 |
Doctoral studies | 5 |
Black people | 16 |
White people | 2 |
Asian people | 1 |
Mixed race people | 1 |
Female | 17 |
Male | 3 |
Age (years) | 37–65 |
Lecturer | 15 |
Senior lecturer | 5 |
A total of 20 semi-structured individual interviews were conducted in English by the researcher between June 2015 and February 2016 in comfortable, natural settings chosen by the participants, which included the nursing boardroom, their homes and offices at the university. The researcher used the semi-structured individual interviews as a data collection method because they allowed flexibility regarding scope and depth during the discovery of the views of nurse educators on how self skills can be developed in learners within an AL environment (Gray et al.
The collected data were transcribed verbatim and analysed manually and independently using Miles, Huberman and Saldaña’s (
The data, including field notes, were then condensed and displayed in dense matrices whilst a record of selection, condensing and revision of entries into matrices was kept to demonstrate credibility of findings. Within matrices, the cell entries were made thicker so that more data were used to derive richer, meaningful themes. The researcher chose paraphrases supported by direct verbatim quotations instead of direct statements, general summary judgements or ratings for cell entries. This was followed by the use of codes to easily identify key information. A record of the agreement amongst participants was kept as the ‘decision rule’ in selecting data chunks for entries. Data entering process in the matrices was kept open as going back to the entered data was important for constant analysis and revision. Lastly, a meeting was later held between the independent coder and the researcher to validate the accuracy of the independently analysed findings as well as to ensure a collective review of the matrices displayed. Transcripts and field notes were used to verify the procedural adequacy of the built matrices. A completed, verified matrix was then agreed on and displayed. The minor disagreements on the matrices that arose were debated and resolved by presentation of the individual record of selection, condensing and revision of entries into matrices, the decision rule and paraphrases supported by direct verbatim quotations.
The independent coder was chosen because they held a PhD and had 21 years of experience in qualitative matrix-building data analysis. Seven (7) follow-up interviews with participants whose interviews were of interest were conducted to verify the accuracy of the transcripts and analysed findings as true accounts of their views. These interviews were arbitrarily conducted in no particular order.
Trustworthiness was attained by attending to credibility, transferability, dependability and confirmability (Lincoln & Guba
The three themes that emerged during the data analysis revealed that for nurse educators to develop good self skills in learners within an AL environment, they need to (1) ensure an AL environment that promotes such skills, (2) engage learners in activities that will consciously evoke authentic self and (3) evaluate the developed self skills and metacognition. The findings and field notes are to follow. There were 20 nurse educators each with a number ranging from nurse educator 1 to 20.
According to the participants, for self skills to be effectively developed, an emotional and psychologically safe environment conducive to AL must be created. In such an environment, learners are enabled to take risks as well as reflect on who they are without fear of being scorned, mocked or teased. Most participants felt that to be in an AL situation was much harder than being in other learning situations, and thus the environment must suit the learning approach. The following quotes support this view:
‘No student will bare their souls and engage in full self skills development unless the learning environment is emotionally and psychologically supportive [
‘Authentic learning is very challenging and … scary … and feeling safe in this environment will allow students freedom to explore the self, to take risks, to trust and respect other people.’ (Participant 3, senior lecturer, 18 July 2015)
‘… authentic learning allows students to take risks, challengingly so … [
The participants mentioned that when learners are engaged in AL tasks, they need to be consciously enabled to think about themselves. The mentioned activities included self-awareness, self-dialogue, self-inquiry and self-reflection – these were viewed as indispensable in the construction of the authentic self. The participants felt that the engagement in real-life situations such as community-based research developed learners’ authentic self. The following quotes underline this theme:
‘We should engage students in authentic tasks that will compel them to be self-aware … [
‘… when students are engaged in research especially community-based research, that is when real self is truly developed … students start to look at life differently from what they have and the problems people in the community deal with … this develops the self that is genuine and real … [
‘… engage students in activities of self-inquiry in order to self-discover [
Eighteen participants stated that well-developed self skills enabled development of metacognition, which resulted in lifelong learning. According to them, learners with well-developed self skills and metacognition were able to effectively solve complex problems. It also emerged from the interviews that the developed metacognition as well as self skills needed to be explicitly evaluated. The following three quotes exemplify the views of the majority of nurse educators:
‘… metacognition is developing and a lifelong learner when a learner, as self … [
‘… we learned in nursing education that with metacognition you are able to solve gruelling, difficult problems [
‘When we, as nurse educators think that we have developed such skills in students, we must evaluate them, otherwise we are not being explicit and honest with our “selves” [
The findings of this study provide sound support for the argument that developed self skills in learners are imperative if they are to make rational decisions and find unique solutions for problems within an AL environment. The findings are discussed below within the framework of the relevant literature.
The participants stated that an emotionally and psychologically safe AL environment develops good proper self skills that usually lead to an improved sense of self-awareness in learners. In such an environment, the learner is exposed to questioning that requires deep, diverse thinking, critical discourse, sharing, being creative and innovative, thereby building autonomy that improves self-esteem and is desirable for sharing multiple perspectives in solving an authentic problem. Learners must be consciously assisted to create such an environment for themselves and by themselves to enable them to freely and openly develop self skills. Within a psychologically safe AL environment, the learner’s inner potentiality is set out, and they are thus enabled to self-actualise (Javadi & Tahmasbi
Fifteen participants also stated that learners must be allowed to take risks to help them find themselves thus developing self skills. To be involved in meaningful learning, the self should have the freedom to try new things, reflect on them and then adjust the course of action if necessary to attain the desired goals whilst building self-confidence that supports a positive self-concept (Liao
Nineteen participants stated that constantly thinking about self through engaging in self-awareness, self-dialogue, self-inquiry and self-reflection activities within an AL environment-assisted learners in evoking the authentic self. These activities can be embedded in real-life learning strategies such as community-based research and global exchange programmes.
A lack of self-awareness leads to failure of realistically assessing oneself, whilst the deficits that one fails to see in oneself are occasionally apparent to others and, as a result, one is then seen as devoid of integrity. In addition to self-awareness, almost all participants also believed that learners must also engage in self-dialogue, self-inquiry and self-reflection.
Negative self-talk is destructive in nature and may result in stress, anxiety, unproductivity, unsuccessful academic performance, and may hinder effective problem solving (Nurbaity et al.
Nineteen participants stated that well-developed self skills in a learner develop an
According to the participants, metacognition develops from well-developed self skills, and whilst all skills must be taught, they must also be modelled and evaluated. Similarly, according to Fauzi and Sa’diyah (
In spite of the limitations mentioned below, the findings proved to be relevant, robust and provided rich description on how learners’ self skills can be developed by nurse educators within an AL environment. The study adopted a qualitative research design to answer the research question using a limited number of participants in a higher education institution, which limits the generalisability of the findings. The study, however, could be replicated in similar contexts by other interested researchers. Only the views of nurse educators were explored and described, and not those of learners.
Whilst self skills are imperative in an AL environment during training as well as in healthcare settings, knowing self is not without its pitfalls. The process of knowing self can conditionally contribute to increased stress and depressive symptoms (Nakajima, Takano & Tanno
Nurse educators should not attempt to facilitate self skills if they themselves lack such skills. For a nurse educator to be able to facilitate self-awareness, they need to be self-aware (Ndawo
The development of self skills and metacognition is challenging and time consuming as these skills develop, grow and improve over time. However, once developed, the self is enabled. It is thus recommended that nurse educators exercise patience and perseverance to assist learners develop these skills properly because the more the learners use these self skills, the more readily they will develop them (Jumari et al.
The self makes rational decisions and finds effective solutions for authentic problems. The findings in this study indicate that the development and use of self skills may be beneficial to individual learners and communities across a range of domains. Nursing education should empower learners with good self skills that will help them to adapt to the rapidly changing healthcare environment (Driscoll
The author wishes to thank all the participants of the study, Professor Mary Chabeli and Professor Anna Nolte from the Department of Nursing at the University of Johannesburg for their supervisory guidance and support.
The author declares that she has no financial or personal relationships that may have inappropriately influenced her in writing this article.
I declare that I am the sole author of this research article.
The research was approved and permission granted by the Faculty of Health Sciences’ Research Ethics Committee (REC-01-123-2014) of the University of Johannesburg. Informed consent and additional consent to use an audiotape recorder was obtained from the participants after explaining what was expected of them in the research and truthfully attending to their questions and concerns about the research.
This research study received a Thuthuka grant as part of the PhD Track (grant number TTK150706123349).
Data sharing is not applicable to this article.
The views and opinions expressed in this article are those of the author and do not necessarily reflect the official policy or position of any affiliated agency of the author.