TEACHING AND ASSESSING IN NURSING:
A WORTHREMEMBERING EDUCATIONAL EXPERIENCE
Aik. Halarie MSc, BSc (Hons), R.N., Hellenic Red Cross, Athens – Greece
ABSTRACT: Teaching and assessing are two
teaching and assessing nursing students.
dimensions within the same learning process
Significant factors which influenced the
rather challenging and demanding. Nor
assessment process are also critically discussed.
assessing can stand alone neither teaching can
A meaningful mentor – student relationship
be considered comprehensive if evaluation has
facilitates the acquisition of knowledge and
not taken place. Personal characteristics of the
skills but also assists the creation of a worth ?
assessor and successful management of the
remembering educational experience.
factors which interfere within this learning
process in classroom and in nursing clinical
Keywords: assessing, facilitation of learning,
practice are essential for ensuring that learning
teaching, nursing students.
takes place. This article attempts to discuss the
role of the teacher as a facilitator of learning in
n the last decades nursing education, as many other fields of nursing, is undergoing fundamental
changes in order to meet the needs of a rapidly changing society (Slevin and Lovery 1991, Quinn
I1995.) These changes entailed the adaptation of new roles for all those who were actively involved
in nursing education: teachers, tutors, practitioners who act as mentors or preceptors for students in
clinical practice. Significant influence on these changes has been the application of different teaching
theories in nursing. In particular Carl Roger’s humanistic theory (1969) initiated a new approach to
teaching and learning, widely used by many teachers and has been adopted as a philosophy by many
academic institutions worldwide. Rogers (1983) believed in the innate potential for growth and
development of each single individual and supported the notion that the teachers’ role should be
concerned with the facilitation of the learning experience (Bradshaw, 1989). In this article we will
attempt to explain the characteristics of the role of the teacher as a facilitator of learning in teaching
and assessing nursing students. Significant factors which influenced the assessment process, vital in
ensuring that acquisition of knowledge takes place, will be critically discussed.
The facilitator and the learners
According to Furzard (1995), the term ‘facilitator’ was considered by teaching circles as more
affirmative term than the term teacher, although this does not release the facilitator from the process
of teaching. Nursing teachers are being encouraged to use teaching methods which will enable
students to be more responsible for their learning (Lister 1990), and that the application of these
methods presupposes different orientations and attitudes. Teachers have to adopt the role of
facilitator of learning (Coulter, 1990), as according to Rogers (1969) we cannot teach another person
but we can only facilitate his learning. As Cross (1996) reports, the application of the humanistic
approach into the teaching process involves a total reappraisal of the role and function of the teacher.
The teacher who acts as a facilitator of learning is seen by Rogers (1983), as a provider of learning
resources and as a person who simultaneously shares his knowledge and his feelings with the
learners. Quinn (1995) underlines the importance of the relationship between the learner and the
facilitator characterizing it as a central element for meaningful learning. This relationship requires
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particular qualities of the facilitator such as warmth, genuineness, trust, acceptance and empathetic
understanding. (Rogers 1983). According to Burnard (1992), these qualities entail that the facilitator
treats others as equal human beings with interest in the relationship which is then created between
them and himself.
As the aspiration of Rogers’ theory is the ‘fully functioning person’, the best approach for the
facilitator to assist the learners to perform at their full potential, is to know them well (Furzard 1995).
Many factors although influence this process such the workload in the ward and the time factor which
often disrupts discussion at rather critical learning stages. The next step for the facilitator is to create
a supportive educational environment, which will provide a safe basis for meaningful learning
(Marson, Hartlebury, Johnston and Scammell, 1990). Rogers explains that significant learning is more
likely to take place when students perceive the relevance between the topic under discussion and
their own learning commitment to learn. The learning environment should encourage collaboration
(Mc Millan & Dwyer 1990) as according to Burnard (1992) learning is a partnership. McKenna (1995)
reports, that all the members of the group including the facilitator become a community of learners.
Mc Millan and Dryer (1990) sees the teacher and the student as key players in this prospect and
learning as the educational environment and the method or approach of the group of actors. The
facilitator should accept and encouraged learners to be active, should be able to recognize their
differences in personality and should acknowledge the prospect of making errors by tolerating
Hinhcliff (1996) underlines that in order to bring this type of teaching, special skills are required from
the facilitator, in building a long?lasting relationship, such as to listen and respond consistently, to
share personal experiences and to assist students to identify their attitudes and their base of
knowledge. Also Brookfield (1986) comments that students’ past experiences should be used as
educational resources and that teachers should be willing to share their experiences with learners. In
particular this is the critical constituent of the rapport between facilitator and learner that provides a
feeling of flexibility and openness (Brookfield, 1986).
The scene of learning
The physical environment also has an important role in the facilitation of learning, as the
rearrangement of the seating within a classroom may minimize some of the barriers between the
teacher and the learners (Quinn, 1995). This would be more preferable as it allows a degree of
openness, where each member of the group can have eye contact with all the other members and
participation is considered more achievable (Ewan, 1996). Also the lighting and adequate ventilation
and air ? conditioning of the room, which additionally contribute to an effective learning environment
have to take into account. As most significant learning is acquired through doing (Rogers, 1969),
some teaching sessions include demonstration of a skill particularly within a practice – based
profession. As adults are competency based learners, they should be given the opportunity to apply
the knowledge and experience gained at the lectures. According to Quinn (1995), creating an
environment that requires learners to be actively involved is a very important aspect of facilitating
their independence. Hincliff (1992) underlines that once the teacher adopts a student center ?
approach and acts as facilitator of learning; this implies that students would be allowed to develop
their skills at their own pace. Apart from the relationship between facilitator and learners and the
external conditions, the process of facilitation goes over certain stages which Burnard (1992)
characterizes as key features. Adapting a student ? centered approach the facilitator should focus upon
learners’ needs and set explicit educational goals.
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Critiquing the approach
The approach is not without its problems. The openness between the educator and the learner can
create an atmosphere of mutual trust, but could possibly lead to disclosure of personal information,
which might require further support by other professionals such as psychologists or counselors in
some cases. The teacher should be characterized of sensitivity, understanding and the wisdom to
know when more specific professional help is required. However it would appear that humanistic
approach is rather suitable for the education of nurses who are expected to use such an approach in
the care of their patients. The teachers while adopting such an approach have to diminish traditional
approaches, adopt an open stance towards learners and continually reflect and evaluate their practice
as nurses and educators. In this way students will in turn help themselves to become caring nurses
and reflective practitioners, so essential characteristics for a humanistic profession. Educators
however have to early assess their limitations in nursing and as reflective practitioners acquire the
latest knowledge and experience for their professional development and for the benefit and support
of the students.
Assessing in nursing
Assessment has always been a sequence of teaching, as teaching and evaluating are integral parts of
one learning process (While, 1994). As While (1991) states, learning which she characterizes as
sophisticated, is a complex activity and its evaluation part consists a ‘stubborn problem’, which always
presented many difficulties for the assessors (Wood 1986). The complexity of the assessment process
is magnified, as in nursing education theory and practice are often assessed simultaneously and this
assessment according to Andrysyszyn (1989) is three?dimensional. The three dimensions which
ought to be assessed consist of the cognitive, psychomotor and affective domain of learning. The
assessment of the three domains provides a more holistic picture of students’ performance or
students’ abilities upon specific competencies. Andrysyszyn (1989) claims that the evaluative process
poses a challenge but also offers a tremendous degree of responsibility for the nursing faculty,and as a
consequence for all those who are involved in the education of students. Clinical evaluation poses
problems for nurse educationalists (While 1991) as many factors affect the validity of the assessment
process in clinical practice (Girot, 1993).
Additionally adjustment to the environment where assessment takes place has to be considered.
While (1991) underlines the importance of the adjustment process that the student has to undertake
as he is allocated to every clinical placement. This include physical adjustment but also adjustment
with the patients and the other members of the staff. Meanwhile the student is adjusting himself to the
placement he/she is simultaneously learning new skills and is sometimes continuously assessed.
While (1991) characterize this less than an ideal situation, but the outcome of this process reveals
another aspect of dynamic education, the importance for further and on – going planning with the
student in order to achieve specific performance criteria. This gives a very energetic character to
nursing education as it indicates the cooperation between assessor and the student through a
mutually agreed plan, which can be review each singe day or week according to students’ personal
educational needs and performance.
Considerations of the assessment process
Another important factor which influences the assessment process is the relationship between the
student and the assessor. As Reilly and Oerman (1992) asserts, evaluation should be a growing
experience and key characteristics for this relationship should be mutual trust and respect (Nicklin
and Kenworthy 1996). With this friendly approach the assessor tries to evaluate the incidence of
other physical or emotional factors for the student such as fatigue, stress, which additionally impede
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upon students’ performance (Stoker 1994). Quinn (1995) highlights as main factors which influence
the assessment process, students’ state of preparation, the level of anxiety and the presence of others
while evaluation takes place. She claims that the presence of others may affect students’ feeling of
responsibility and may modify the degree of their decision making. Students when another person is
present while they are being assessed may have the impression that the main responsibility lays upon
the teacher – assessor (Quinn 1996). Although this may be the case, as students are not yet qualified
nurses, there is a challenge in experiencing this feeling, in order to become responsible practitioners.
In relation to the students’ preparation except their personal work, knowledge or skill exercise, Stoker
(1994), makes a link between the level of preparation and the feeling conveyed by the assessor about
the importance of the assessment as a process. From the assessors’ point of view the assessment
process can be influenced by his personal feelings and attitudes towards students (Stoker 1994). Even
external features, general characteristics, such as the social group the student comes from, can shade
the assessment of learning (Hull 1994). For this reason Rowtree (1987) emphasizes that the evaluator
should go beyond those characteristics and students’ behavior. The assessor has to understand and
simultaneously be aware of students behavior, verbal and non verbal. This adds one more
characteristic, necessary skill for the assessor, self awareness. Personal bias or prejudice about the
learner, or the perceived level of his knowledge or skills may influence the assessment process and
the relationship between the assessor and the student.
Another difficulty for the assessor could be the lack of his/her familiarity about the program of studies
of the particular student (Stoker, 1994). This would lead the assessor to establish a different level of
the assessment criteria, which the learner might not be able to achieve (Stoker 1994). Finally
environmental factors can influence the validity of the assessment process. Stoker and Hull (1994),
asserts that when the students perform at their everyday working environment, rather than in a
simulated surrounding, this can provide an accurate, as possible, representation of their abilities.
When the students are aware where they can find the necessary equipment, the resources needed to
facilitate the performance of the nursing skill; this can provide them some degree of ease. This has to
be taken into consideration in relation to students’ adjustment to the environment, as combination of
the two difficulties can cause major problems for the students, if assessment for example is taking
place during the first weeks of a student’ new clinical placement. Additionally a very busy working
area with many distractions may result in a lack of concentration upon the skill under assessment for
both the student and possibly the assessor. Reality however is often as demanding as described but
nevertheless this should be taken into account by the assessor for the educational benefit of the
nursing student and the patients.
It can be concluded that teaching and assessing nursing students is a challenging process for both the
student and the mentors. Personal awareness of the assessor and control of the factors which
interfere within this process, are essential key?characteristics for its safe ? guarding. Furthermore an
open relationship which supports critical discussions between the teacher and the students can create
a supportive learning environment and can bring to light those factors by both sides, hopefully before
they become problems or established prejudices. By this way action planning can be used for
scheduling how to protect the validity of the assessment process and assessment can be used for
evaluating both the whole process and its final outcome.
Teaching and assessing are two dimensions within the learning process. Nor assessing can stand
alone neither teaching can be considered comprehensive if evaluation has not taken place. Clinical
placements are where theory and practice is integrated in the real world of healthcare (Pellatt, 2006).
Because clinical placements are not always as attractive and welcoming to the students (Castledine,
2002) a good mentor – student relationship will allow not only sharing of new knowledge and skills
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between the two parts (Morton – Copper and Palmer 2000) but also will facilitate the creation of a
valuable and most importantly worth ? remembering educational experience.
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