Week 10 Obligations as a Scholarly Teacher

In pulling together the three courses of thought regarding what is a scholarly teacher, the issues of learning knowledge and truth (epistomology) and the ethics of teaching, I found it important to consider each area as obligatory considerations in order to mature as a teacher.
The philosophy and theory of teaching have far reaching considerations and implications for the teacher who wishes to strive for self actualization, function with excellence and be fully cognizant of students' needs, demands and growth.
My concept of what is a student is formed by studied literature and reasearch, personal experience as a student in observing students while I teach them. The analogy of explorers in an area that is foreign or so vast that the area requires further exploration can be applied to students exploring an under-sea garden. The teacher can be envisioned as an eight armed octopus juggling multiple roles such as educator, course administrator, mentor, supervisor, faculty member, professional expert, etc. In active teaching the eight arms could be seen as manipulating the learning media, fielding questions, using various teaching approaches, providing feedback, maintaining a safe environment, acquiring persoanl learning, etc.
Regardless of the metaphor, a teacher must be conscious of the holistic nature of education and the obligations attached to this important role.
Two considerations that really came to the forefront for me were acknowledging and ethically weighing hidden agendas and determining assumptions underlying knowledge claims.
It is important for me to continuously develop my identity as a scholarly teacher by being grounded in critical reflection and holding myself up objectively to the rigorous standards. These are obligations to self as a scholarly teacher.
In exploring if learning in nursing (education) could be objectively measured, I discovered more specifically how important operational definitions are in determining what "measuring" means. I made the error of defining the term measurement through the help of professors and peers yet quickly falling back on the common, less specific use of the term in discussing the posed question. I also learned that the specific competencies are subjectively based and are generally measured by performance and behavioural criteria that are judged by others (subjective). The use of  competencies in order to determine whether or not a nurse should be licensed, continue to practice or require further education was not nearly as objective as I had been lulled into believing! That was unsettlling. I struggled. I grew.
Further exploration into the theories and philosophy of scholarly teaching lead me down a path of discovery into the necessity of ethics. I eventually developed a list of what my hidden agenda exists of and it is all centred on goodness. This tangential thought regarding ethics lead through the leadership of professors and peers' insights, questions and inquiries to exploring my mega beliefs, espcially in the origin of goodness. I was especially intrigued when Prof Potter shared that Plato espoused the idea that mankind is aware of goodness prior to taking on boldily form. I argued that an infant and even a two year old is quite selfish, thus adults need to learn somewhere along the line to consider others and strive for what is helpful, useful, and desireable for mankind; in other words to learn goodness. I argue that base human nature is selfish thus goodness comes from a higher level of existence, from a higher power. I cited the only human example I am aware of in the written word who epiomizes goodness and that is Yashua who did no evil, was called the sinless one, and represented the higher power of that source of goodness.
My obligations as an ethical, scholarly teacher stem from what I espouse as my mega beliefs. In attempting to determine whether nursing can be measured objectively, I found that what I considered as true was actually less rigorously defensible than I had originally thought. In exploring my own posed question and following my 4 classmates blogs, I found that there is rarely any specific, right answer to high level (Rasmussen type) questions.
It is fascinating that it seems there is a level of faith required to believe any set of ideas. In the last class Jules quoted the bible: "You shall know the truth, and the truth shall set you free" (John 8:32). When science has not shown or cannot measure (and I use that term precisely) goodness, and researchers can only speculate about it, yet I have found full assurance that the freedom in knowing the Truth about goodness must be learned from the higher source of Goodness. That learning can come by teachers who have learned goodness, through the ancient words (Logos) about goodness, and by directly experiencing goodness and learning about it by a direct relationship with Yahweh God (via Yashua His son) himself.
My obligations are to God by functionning in goodness in all my dealing with others as a scholarly teacher and as a person. When my base human self gets in the way, I have faith to believe that the grace of God will cover my many shortcomings through His goodness.
The foundations of scholarly teaching stem from a system of beliefs: mega beliefs, beliefs about who I am as a scholarly teacher, how I conceive of students, what the relationship between teacher and students looks like, what is knowledge and what ethical considerations must be heeded.

Extra Blog

I have taken to heart what Prof. M. told me that I did not post a true blog in past weeks. In response to that, I would  like to expand on my comments I posted in response to Ahmed's blog this week. He really stimulated thought along the lines of determining philosophical foundations for teaching and even life!

Interesting idea of philosopher kings establishing a rule of goodness, but where along the line did goodness come from if nothing can be definitively proven, it is ascribed to intuitive thought, and base human nature needs to learn goodness?

If I'm following that line of thought correctly, then the outcome is that we cannot prove ultimate truths through scientific evidence, and thus any belief system based on this leads to a paucity of knowledge to base any mega beliefs upon.  Vain philosophies.

If this is so, then any philosopher king's belief system using only what can be measured or physically sensed, to determine what is good, can be faulty at best. Where does goodness come from or even the idea of it?  What of the adage that power corrupts and absolute power corrupts absolutely? Kings weild great power. Every powerful nation (a.k.a. kingdom) in the past has failed. Is it because corruption has crept into the powerful even where goodness was the original intent? Does that corruption come because of human nature which is selfish at its core? Unless children learn to ascribe to a higher good as they mature into adulthood, then selfishness reigns (note a 2 year olds' temper tantrum).

If it follows that when self interest reigns, any means to an end is valid, such as violence (electrocution, shooting, stoning) or devaluing others (genocide or making second class citizens of people who are unlike those who rule [different races/religions/cultures]).  If we do not ascribe to goodness, which is outside of mere scientific knowledge, then self gratification reigns and mankind is damned to a living hell.
Where does goodness come from if humans must learn to consider others'? It takes until the early 20s for the brain's limbic system to fully mature (where the seat of emotions lies). At this point the lessons on goodness we have learned (or not)take deeper root [maturation].

This brings me to what we cannot measure, taste, smell, see, hear or touch; the spiritual. Phenomena existing outside of what can be physically sensed or measured is outside of the realm of what science can prove, pointing to a power beyond science, suggesting God. In ancient writings, He has many names and one of them is Goodness (Psalm 144:2).

Looking to history, mankind has failed repeatedly to rule itself well, and has failed through selfish ambition and corruption; a lack of goodness prevailed. Civilizations rise and fall. I believe that a good God who exists outside of what can be measured, yet creates unmeasurable phenomena, who provides guidance into what is good, is more powerful than man and is worthy of following. In order to have peace and justice we need to ascribe to something above and beyond scientific evidence and speculation.

The value of pursuing goodness through the application of loving kindness versus base selfishness and corruption is worthwhile for mankind to pursue; for me life is not worth living if there is no good.

Vain philosophies lend emptiness to life. Following a person who epitomizes the Good God is the only philospher king I want to follow. Science does not provide the goodness we need to value in order to have a decent world to live in.

Historical writings point to a man without such corruption who only did good and is known as the sinless one. He epitomized the good God on earth. He never drew a sword, never devalued the weak, never took land or belongings from others, He  only did good. His goodness is what I know underlies my teaching and is a growing part of me, thus I at least attempt to knowingly bring that unannounced curriculum into my 'classroom'. Base on the teachings on goodness of Yashua, I have determined that my hidden curriculum includes living what I believe:

• Love is a powerful choice / action
• Sanctity of Life
• Property rights
• Safety rights
• Freedom to choose if it does not harm others
• Preserving dignity
• Listening is a gift we should all share
• Authority must be upheld where it is not corrupt
• Unjust/unfit rules must be challenged
• The weak / vulnerables’ rights must be protected
• Be ready to forgive a person (not a corrupt act)
• Pursue peace but not at all costs
• Preserve confidentiality if it does not harm
• Right to hear truth
• Use the environment to advantage without destroying it

I do recognize that others have widely varying beliefs, but unexplained phenomena on the spiritual plane which have brought me good is enough evidence for me.

Competencies & Self Reflection Gauges: Ethical Consideration

            I see that I have drifted off topic and off blogging to a state of confusion and uncertainty as to where to head. I spent the week reviewing and pondering the syllabus, primer, publications, my comments and peer and instructor comments (plus resurrecting my 93% dead computer- so sorry for the delay!). The syllabus was a bit encouraging (?) in stating that the state of “discomfort, frustration and confusion…is normal, expected – and temporary!” So, here’s striving for timely comfort, peace and clarity!

            This week’s homework question was: Where in the course of my inquiry did I move into ethics? I’m not sure that I did, as I bogged down in my blogs. The course moved from teacher identity to epistemology where beliefs and knowledge claims can cause conflicts between students and teacher, and this is where the resolution of this can certainly bring ethics into the mix.

            When looking at how to gauge learning in nursing, I looked at the use of defined competencies. Students who are failing sometimes will argue the definition of professionalism when they are informed that their behaviours fall short of expectation. It is when those behaviours are listed that students realize the gauge being used is their performative expression of learning. I have learned through my inquiry that the determination of affective learning is subjective and thus is fertile grounds for ethical dilemmas in teaching.

            This is where I took my original posed question “how can the criteria to grow cognitively, performatively and affectively be objectively measured” to “how can it be measured.” The biggest underlying assumption was that the criteria were objective and acceptable. I clearly found that as the criteria could not be rigorously measured, I ended up wavering between whether it was acceptable as it stood or not. I then moved to the thought that “current methods of measurement of learning in nursing might not be adequate”. Frustration set in as I considered that the criteria upon which I based my own competency as a nurse for 2 ½ decades and the pass/fail determination of my students, might be flawed! How then could I ethically make a determination of my students’ (short term) futures [pass/not pass]?

            Dr. Ruth Ludwig (1999) voiced a common fear in nursing that if we do not competently regulate our own profession, then we will be dictated to in how we gauge competence. She made an interesting statement that “commonly, professions use external measures for assuring competence…(via) licensing exams… continuing education… orientation programs, and graduation from an accredited program”. She also made a sobering statement that “laws and rules are generally considered to uphold the lowest minimum standard for practice,” meaning that “legal behaviour is not necessarily the highest ethic."  

             To offset the minimal measures of competence that external measures provide, nursing generally also uses reflective practice to personally determine areas for improvement.  I agree with Ludwig that “competency is a complex construct that requires numerous measures.” She suggests that compliance with external competence measures is necessary, in conjunction with self-reflection to “reflect ethically about competence.”

           In defining self-reflection, Ludwig ties in experience and job role with an individual’s “spiritual, physical, intellectual, and emotional well-being.” She encourages nurses to ask when personally assessing their competencies: “are external and (your) internal measures congruent?”

           I have progressed to the idea that determining learning in affective, cognitive and performative realms cannot be solely determined by competencies. I agree with Ludwig that self-regulatory behaviour is also necessary.

Reference: Ludwick, R. (1999) Online Journal of Issues in Nursing. Silver Spring, MD: The American Nurses Association, Inc.
 

Evaluating Claims

One major knowledge claim that I made in one of my posts was that “the standard of replicability will help us determine whether we know that caring behaviour promoted healing.” The reason for pursing this evaluation is that a standard determines the knowledge claim.

Criticisms: A) Definitions and Meaning - “caring behaviour” and “healing” need to be carefully defined.

Points: Healing is defined as: heal (h l)  v. healed, heal·ing, heals

            v.tr.     1. To restore to health or soundness; cure.

                        2. To set right; repair: healed the rift between us.

                        3. To restore (a person) to spiritual wholeness.

            v.intr.              To become whole and sound; return to health.

                        Reference: http://www.thefreedictionary.com/healing

            heal·ing /ˈhilɪŋ/    [hee-ling]

            adjective 1.

curing or curative; prescribed or helping to heal.

                        2. growing

sound; getting well; mending.

            noun   3.

the act or process of regaining health: a new drug to accelerate healing.

                        Reference: http://dictionary.reference.com/browse/healing

Based on these definitions and my own conception of what “healing” is, I define it as "progress, growth or advancement toward what the healer or client declares as a state of improvement in any area of health (biological, psychological, social or spiritual)."

            car·ing (kâr ng) adj.   Feeling and exhibiting concern and empathy for others: "We      formed Generations United to argue for a caring society" (Jack Ossofsky).

            Reference: http://www.thefreedictionary.com/caring

           

            verb (used without object)

            7. to be concerned or solicitous; have thought or regard.

            8. to be concerned or have a special preference (usually used in             negative constructions):

I don't care if I do.

            9. to make provision or look out (usually followed by

for ): Will you care          for the children while I am away?

            10. to have an inclination, liking, fondness, or affection (usually   followed by for ): Would you care for dessert? I don't care for him very much.

            Reference: http://dictionary.reference.com/browse/care

Based on these definitions and my own conception of what it is to care, I define “caring behaviour” as "a set of actions that evoke positive feelings in the receiver or even the giver that are measured by the fact they are reported." This reporting can be measured in order to meet the replicability standard for this knowledge claim.

Criticisms: B) Evidence – the point made was that conditions need to be carefully controlled for contaminating contextual factors. Studies, which outline context and parameters and state limitations, are gathered into meta-analyses where such details are examined, peer reviewed and judged. The use of constants and control groups in the experiments or studies assists in strengthing the use of such evidence. The use of multiple studies lends itself to the replicability standard as well.

Criticisms: C) Consistency and Reliability – the need to narrow the focus of studies in order to control for inconsistencies is recognized in nursing research. The closer the studies are in similarities increases the reliability and applicability to the broader population. Studies on increased rates of healing are measured in various ways: decreased length of stay, wound repair time, counseling intervention resitivism, decreased scores on psychological measures (such as the Beck Depression or Anxiety Inventories) and the like. The more consistent the statistical scores are in showing significance in the trends and the statistical realiability and validity scores meet the prescribed standards, the more we can state that the studies are replicable and useful to measure that “caring behaviour promotes healing”.

Now I need outside, skeptical, inquisitive, scholarly teachers to critique these arguments to see if I am walking into common errors and fallacies yet again! Thanks for your attention!

Week 7 Blog: Evaluating my Claims & Engaging Feedback

My re-stated, posed question is: “How can scholarly teachers evaluate students’ cognitive, performative & affective learning in nursing education?” (4 October 2012).  In exploring this question, one of the major “knowledge claims” I have asserted through my blogs is:

“Well defined competencies provide a basis for evaluating nurses’ learning” (30 Sept).

As an important focus to my inquiry, I am asserting this is true from the viewpoint of some of the 12 possible questions I could ask (consistency, non-contradiction, reasoning, assumptions, inaccuracies, implications, connections, relevance, evidence, meaning, reliability & definitions).

Meaning: One standard for determining “knowledge” of this claim is through the indicative statement, capable of justification. As competencies are the common standard across North American Colleges of Nurses, they are accepted as meaningful. Other ways of evaluation are less rigorous and not as standardized, begging the question of them bearing meaning.

Evidence: Those standards have been used to successfully remove licensure from nurses who have harmed clients and fail to meet specific competencies. The standards have also been used to remove dangerous nurses, deemed so because they have failed to demonstrate behaviours that, where absent, have harmed other clients. Statistical evidence shows the trends of client harm where competency standards are not met.

Relevance: The claim for competencies helps to address the core question of how to measure learning, as the lack of competence per the listed standards is a measure of the students’ lack of behavioural evidence of learning.

Consistency: The use of thoughtful standards is the norm in this society and failure to meet standards constitutes a lack of competence or at least adherence/compliance; this is the purpose of a marking rubric in scholarly teaching.

Non-contradiction: The assertion that competencies form a basis for evaluating learning does not negate the possibility of other forms of evaluation being useful.

Reasoning: The ideas between the posed question and the assertion are connected and the arguments offered in the other evaluation questions are reasonable.

Assumptions: The assumption, that competencies are accurate measures of learning, are reasonable insofar as the criteria for measuring achievement of those competencies relate the students’ behaviours. The assumption that all three domains of learning can be evaluated is reasonable, albeit in a limited sense in some situations.

Inaccuracies: In exploring the posed question in previous weeks through the Blogs, inaccuracies were identified, thus the posed question was modified. Operational definitions were overtly stated in order to clarify fuzzy ideas in the question.

Implications: If we accept the claim that competencies can measure learning, then we have to accept that learning can be measured in all three learning domains and those measurements are accurate.

My peers and professors have challenged my statements and assertions and have helped me to form a better understanding of my claims.

Beth stated (date 14 Oct)” I wondered if frustration squashed your enthusiasm with a sense of needing to shift from subjective outcomes to objective outcomes to somehow provide credibility? Why? Is there really objectivity? Is this self deception (Mullaly, 2010)?” I have to agree with Beth that in exploring how a true justifiable belief must be dissected and supported in order to give it honorific status, (make it defensible), is frustrating and my enthusiasm has been dampened if not quashed in pursuing my posed question. The objectivity in measuring the affective learning domain seems non-existent and begs the question ‘how much subjectivity is acceptable in measuring learning’ or even ‘is it possible’. The use of competencies still have a significant subjective bent.

Ahmed stated (date 25 Sept) “about performative learning… this is mainly skills, as opposed to cognitive which is mainly declarative. ..M. Potter's CDCA… says, if you know about something or know why- that is cognitive. While, if you know how, that is performative.” In exploring how to evaluate learning, I’ve discovered more and more that the different domains require different types of measurement to determine if learning has occurred, if indeed it can be evaluated. I continue to believe that a stated standard is necessary to determine a given level of competence. If we have no standard or competency, then where is the commonality in assuring the public that any given nurse is competent and safe? That he/she has learned nursing?

Jules asked (date 30 Sept) “since the assessment is performed by an assessor and based on his or her's opinion - who assesses the assessors?” This is essentially the same issue Beth brought forward. The subjectivity takes us in the circular look at competencies and how they are applied in order to measure achievement. This brings me back to the discussion of how arbitrariness expands on a continuum to subjectivity and reaches over to objectivity. It seems a matter of degree and begs the question of how much arbitrariness is acceptable in interpreting competencies.

Prof Potter stated (date 1 Oct) “It seems to me that what you're really looking for here are defensible judgments. The information you share in your comment, regarding law and medicine, reinforces that last point, I think. In each case it seems to be people searching for ways to objectively measure what can't be objectively measured. The major point here is: If what you wish to measure can't be measured, then whatever measurements you end up with will never be valid. A concern!” This goes back to Beth’s “squashed” statement. I guess I desperately wanted to cling to the idea that the competency system set up to measure quality nursing was appropriate. I shakes the foundation of what I’ve believed for over 2 decades about my profession. I’m hoping the exercise I competed above shows that competencies are useful, although they are not objective. I’ve had to let go of that idea!

Anna stated (date 9 Oct) “I was wondering if the rubric designed is universal as the expectations or would each teaching approach evoke a unique rubric to measure the cognitive, performative and affective domains.” This is similar to Ahmed’s discussion point. The discussions seem to point back to the variety of teaching/assessment techniques to promote learning.

I definitely need to explore other alternatives to evaluating learning beyond competencies.

Week 6: Follow Up to my Gift

Jules, You are right that I focused on how to assess the competencies, as that was part of my posed question I’ve been pursuing. I assumed that the lecture halls and labs for base knowledge and actual supervised client contact would not change in teaching, based on my proposed competencies. For the methods, I was assuming assessment, planning, intervention and evaluation were all to be modeled and taught, then measured against competencies for achievement. You also asked how I will assess professionalism and accountability. Professionalism is measured by following the policies, procedures and regulations set out by the health institution, the university and the CNO; it is also dress and hygiene, considerate language, behaviours showing respect for clients and other professionals and adhering to the Canadian Nurses’ Association, Code of Ethics document.

Ahmed, I could not find your commentary on my blog– sorry!

Anna, You asked how nurturing can be taught, where and how is it assessed. Although I consider nurturing to be more pronounced in some people, it is the role of the scholastic nurse educator to not necessarily engender this in students but to help make it overt behaviour within socially acceptable manners. I agree with you that professionalism does include ethics. Thanks for the CBC link!

Beth, Nurse leaders in Ontario at the time developed the CNO competencies, but I'm not sure when they initially came into existence It is interesting to consider the political climate at the time, as it actually was when nurses were lobbying for more rights for self regulation and autonomy in delivering health care, separate from physicians. You asked how I propose to assess nurturative behaviours and those are typically measured by attentive listening, open body language, hand holding, brow soothing, hugs, encouraging words, teaching behaviours and hand over hand guidance.

Thanks for all the feedback, Prof Potter. I want to address a few points you brought up. Bevis' theory includes the ideas of nurturative interventions (=nurturing), protective, which you equate with ethics and the third is generative interventions, where nursing attempts to stimulate growth and improvement. In the affective realm, protective nursing behaviours would certainly include ethics, such as the rights to privacy, confidentiality and self determination in healthcare decision making.

Regarding "competencies that reflect public service and professional self regulation," these would include lobbying, registration and licensing, ongoing education through reflective practice and discipline of errant members.  "Ethical practice" is stipulated in a document called the Canadian Nurses’ Association (CAN), Code of Ethics which defines ethical nursing practice.

I believe accountability is "necessary" in order to preserve client dignity, promote and improve health and ensure safety of clients. I agree that not all areas of proposed competencies overlap all three learning domains and you came up with the ideal argument (basic anatomy) for that!

You also suggested that I should be careful about the implications of tying professional practice to "evidence-informed ideas". Professional nursing practice has been closely tied with evidence! In order to “do” nursing in other words, practice it, the choices for action should be evidence based, thus professional nursing practice should be grounded in evidence wherever possible. This shift in nursing circles from the term “evidence-based” ideas to “evidence informed” opens up room for creativity and critical thinking and unique solutions for individualized problems.

Week 5: Gift of a Challenge...What no competencies?

My “gift of a challenge” was: “Say my discipline didn’t predetermine the competencies graduates are supposed to have, what competencies would I choose, why those particular ones, and how would I help students learn them?”

            For a starting point, I refer to the College of Nurses of Ontario’s mission and vision statements: “Our mission is to protect the public’s right to quality nursing services by providing leadership to the nursing profession in self-regulation;” Our vision is “excellence in nursing practice everywhere in Ontario.” The National Competencies document describes that quality care as being “safe competent and ethical”. There are 123 competencies that must be met for ongoing licensure.

            I would choose competencies that meet the core reason for the existence of nurses, premised on Em Bevis’ theory. A nurse’s role is to provide care in preventative, nurturative and protective ways. Any behaviours that reflect safety, nurturing and ethics would be a start for measuring competency. By also using the foundational systems theory of care, those 3 levels of care can be applied to individual clients, families, communities, nations and global health care.

            I would initially choose competencies that are more directed to the traditional role of bedside care, promoting preventive behaviours in clients and protecting vulnerable clients, all from a holistic viewpoint of bio-psycho-social-spiritual health.

            Safety competencies are the 1^st level competencies required in order to prevent errors, accidents and psychological harm. Student must demonstrate the ability to apply safety considerations and rules, plus establish trust in therapeutic client relationships. This is similar to the Hippocratic oath physicians are encouraged to adopt, essentially “to 1^st do no harm.”

            Professionalism and accountability must be established before anyone can practice the art and science of nursing with clients, so that is the next cluster of competencies to apply.

            Core facts and evidence-informed ideas are necessary to make quality health care decisions for clients, to increase chances of survival. Based on this, competencies that demand demonstration of basic anatomy, physiology, patho-physiology, pharmacology, psychology, sociology and spirituality would be a next step for competency demonstration.

            Next, competent application of knowledge needs to be measured, usually through the ability to identify prioritized nursing diagnoses, the development of collaborative plans of care and implementation of that plan, followed by ongoing evaluation of client care: the nursing process.

            Ethical practice cannot be overlooked and neither can competencies that reflect service to the public and professional self regulation.

            Whew! Now, how to help students learn these competencies on performative, cognitive and affective levels.

            Once learning outcomes incorporating these competencies have been set, I would establish assessment assignments with corresponding marking rubrics. Those assessment assignments would have to incorporate basic, progressing to advance level synthesis of information, theories and ideas via SOLO taxonomy levels. Teaching/learning theories and evidence point to problem solving and critical thinking as the desirable outcomes to any learning. To that end, case studies asking for students to synthesize information in order to suggest provision of holistic healthcare in preventative, nurturative and protective ways would be a start once basic evidence-informed data is learned. Performance of standardized skills in a lab is also desirable before students attempt to care for clients. I would model and discuss desirable professional behaviours. Written examinations testing recall of expected information would help to establish some evidence of basic knowledge. Supervised care of less vulnerable clients, progressing to more complicated clients as students progress through their nursing education is practical. The use of a variety of learning methods is desirable in order to meet learning styles and to give different perspectives on expectations of competency achievement.