Whitehead (2003) states that one of the many reasons why nurses fail to provide quality health services is the lack of evaluation research activity that is needed to be inculcated in their educational models. Consequently, nurses fail to meet the test of proper health provision.
As a response, various educational models have been proposed for use in developing curriculums for training senior nurses. Though these models have interesting qualities, many of them fail to provide a comprehensive package that caters for all the educational needs of nurses. Whitehead’s own proposed evaluation model has been criticized for being too limited and lacking in wholesomeness.
This research paper seeks first to identify a working educational model for senior nurse curriculums and secondly, to analyse the model with an aim to expose its theoretical framework and its aptitude in light of select learning theories such as cognitive and behavioural. The paper aims at presenting a comprehensive educational model that can effectively design the research utilization course curriculum for senior nurses.
Selected Educational Model
Research plays such as important role in any profession and nursing is no exception. In designing research utilization courses for senior nurses, it is important to find an educational model that encompasses all aspects of research vis a vis health promotion and education.
Whitehead’s (2003) evaluation model is an example of a model that emphasizes on research and gives guidelines on pedagogy in the nursing profession. The reason why I chose Whitehead’s model is because it is research oriented and compared to other educational models, it placing emphasis on health promotion as the end result of learning.
Curriculum design is no easy task. Education administrators often have to research into the right model, right learning theory amidst other considerations such as recommendations from government ministries and professional associations.
All these are important but a good educational model will easily fit into all the above considerations as long as it is apt. however, the course should always govern the curriculum and administrators should be careful to ensure that the curriculum will equip the student with the skills required in the particular course.
Whitehead (2001a) and Whitehead (2001b) provide that a research-based course should encompass the three stages of planning, implementation and evaluation. These three processes have to well structured and systematic for them to achieve the designed effect.
He states that the evaluative model is meant to equip nursing students with the right skills for developing evaluation research activity in health-related nursing practice. Though the model is not necessarily designed for senior nurses, its emphasis on research criteria qualify it to be more relevant to senior rather than junior nursing pedagogy.
Whitehead’s evaluation model seems to include both the behavioural and cognitive learning theories. It places more emphasis on the individual student while advocating for a more teacher-centred pedagogical approach. Additionally, the model seems to require the student to have certain cognitive skills for him or her to understand the curriculum.
Researchers agree that health promotion evaluation should be planned yet continuous. These researchers such as Kiger (1995) and Tones & Tilford (1994) state that such assessment should be based on future decision-making.
The Health Education Board of Scotland (HEBS, 1999) states that, “health promotion evaluation is a research approach in its own right that involves assessing the capacity and/or performance of an intended action for health improvement, in terms of its effectiveness and efﬁciency (p.35).” such evaluation aims at accountability, development of future programmes and knowledge building.
Having looked at evaluation itself, we look at the proposed model to see how it connects to curriculum design for senior nursing course especially those involving research. Whitehead (2003) states that the model aims at directing nurses to adopt evaluation of health data in an orderly, structured and sequential manner.
In the initial stages of the evaluation process, he states that the practitioner or student should first plan what is to be researched and how they specifically intend to go about the entire process.
According to Pirie (1999), “the key to effective health promotion evaluation is clear thinking about the purpose of the evaluation (p.134).” This means that indicators and measuring tools for both process and outcome need to be known beforehand.
Basically, the model outlines the entire process of programme/curriculum design. It states the first part of the process as the consideration of the entire development process which would include; assessment, planning and implementation. The designer should then identify where and when they should consider and introduce the evaluative phase. The designer should then answer the following series of questions;
- What timeframes should be considered?
- Is this a new programme or a re-evaluation?
- Who will be evaluating what?
- What will the setting and context be, i.e. community development, organizational or institutional?
The next part should involve the identification of aims and objectives of the programme which should include the potential indicators that would most likely offer programme success. Another consideration is whether the evaluation phase should be cyclic, longitudinal or ‘one-off’. The designer should also consider whether goals are to be measured in the short-term, medium-term or long-term
The third consideration in the curriculum or programme design is the identification of the right approach to use. Whitehead (2003) states that the approach chosen often determines the suitability of the evaluation method that the designer adopts.
Approach here would mean a consideration of whether the health promotion should be medical, preventative, empowering, educational or socio-political. Naturally, the next part of the programme should be evaluation which would of course depend on whether one is looking at process or outcome evaluation.
Other parts of the process in their respective order should be as follows; determination of methodological triangulation i.e. whether or not to use qualitative or quantitative design, identification of required resources, identification of teamwork processes, and finally evaluation of the overall programme (through recorded results and findings) by looking at whether intended outcomes have been achieved.
Whitehead adds that performance indicators and the components to be put in behavioural programmes such as attitude, values and knowledge should be inculcated into the design.
In simple terms, andragogy is the teaching of adults. Naturally, andragogy is placed in contrast with general pedagogy by considering the differences between adults and children.
Adult education differs from pedagogy in the sense that adult learners; have a broader base of experience, are self-motivated, self-directed and eager to learn, view learning as a solution to particular challenges, see the teacher-student relationship as being reciprocal, have a negative self-concept, are less adaptable, are resistant to tests, have better communication skills and finally, are more affected by physiological factors such as health, audio and visual factors during learning (Knowles, 1984).
Due to the above qualities, researchers state that curriculum design in andragogy needs to be different from that in pedagogy (Knowles, 1984; Daffron, 2003). The first aspect to be considered in such design is the fact the adults prefer single -concept or single- theory theories rather than wide survey courses.
Adults also need to integrate the new ideas they are learning with the information they already have for them to fully comprehend the course. This is why any information that seems to be in conflict with what the learner already has tends to be understood more slowly.
Knowles finds that adults usually feel more affected by errors and as such, they prefer to use less risky methods and will more or less go for what has been tried or proven. Additionally, adults seem to be influenced by use of media such as television, books and programmed instruction and would improve the curriculum if they are to be introduced.
For adults to learn, they need to be motivated by use of applications or how-to courses in curriculum design. Though adults are self-directed, they seem to be more influenced by the group and thus a participatory course design is more successful.
Due to the differences in andragogy and pedagogy, educational models should take into consideration whether their targeted leaner is an adult or a child. In this paper, the evaluative model by Whitehead seems to be more involving and requiring in terms of cognitive capacity and adaptability to new methods.
Though this might indicate a younger target, adults are not limited in cognitive capacity and are therefore capable of fitting into an evaluative model of learning.
Cognitive learning theory
This learning theory looks at human behaviour from the basis of thought process and design. It assumes that naturally, human beings are logical and therefore make choices and decisions that make sense to them.
At times, the cognitive theory seems to stand in contrast to the behavioural learning theories due to the fact that the latter tends to reduce human behaviour to individual dynamics. Nevertheless, the two theories have now been merged in a cognitive-behavioural theory and they are seen to be more complementing than opposing.
In curriculum design, the cognitive learning theory plays a huge role since courses must take into account the cognitive ability of their intended learners. Whitehead’s evaluative model is an example of a cognitive-based educational model.
Naturally, the research student should be able to comprehend the nature of the discourse. This is because information processing is a key element to data analysis and other research processes. Needless to say, information processing is a key feature of the cognitive learning theory.
Behaviourist learning theory
This theory was propounded by B.F. Skinner and it looked at the relevance of behaviour in the learning process (Leonard, 2002). Basically, there are three assumptions on learning that are based on observable differences. The first is that learning occurs when there is a change in behaviour.
Secondly, the individual’s surrounding shape his or her behaviour. Lastly, the learning process is affected by contiguity and reinforcement. In summary, learning seems to occur through ‘conditioning’ of behaviour.
Generally, there are two types of conditioning; the first is the classical which is best explained by the famous Pavlov’s Dog Experiment and the other is the operant theory of conditioning by B.F Skinner (Leonard, 2002). Classical conditioning occurs after frequent exposure to certain phenomena while operant conditioning is achieved through the ‘carrot and stick approach’ of reward and punishment.
Link between learning theories and curriculum design
Interestingly, human beings are unique in their learning abilities. This is why there are so many theories looking to explain human knowledge and understanding. To design a curriculum, there is always need to examine these learning theories to determine which suits most to teaching a particular course (Polito, 2005).
Naturally, learning theories explain the process through which understand things and acquire knowledge and since curriculum design is all about looking for the best approach in pedagogy or andragogy, the two are mutually compatible.
In teaching senior nurses, the curriculum designer has to focus on certain key issues. First, the issue of andragogy has to be considered owing to the known differences between child and adult education. Learning theories come in to assist the designer to decide which curriculum best suits the senior nursing category.
Looking at the cognitive theory of learning, we find that it considers information processing and mental ability as a key determinant in learning. Since most researchers agree that age does not have much of an effect on an individuals cognitive capacity, most educational models are compatible with the learning theory (Kim & Axelrod, 2005).
The behaviourist theory is quite different since it tends to lay cognitive ability on causality rather than ability (Leonard, 2002). However, the intermarriage between the two to form the modern cognitive-behavioural theory has produced a learning theory that can be suitably applied in andragogy.
As seen above, the differences between nursing education for seniors and juniors has a significant effect on the particular educational model to be used in curriculum design. Additionally, we have seen that the research course is unique in its requirement of a model that best suits the unit in terms of data analysis and evaluation.
Whitehead’s evaluative model seems to be an apt educational model due to its orientation towards the nursing profession, research and human cognitive abilities. It seems to be the right model for designing a research utilization course curriculum for senior nurses due to its compatibility with both cognitive and behaviourist theories of learning and andragogy.
Daffron, S.R. (2003). Andragogy. Retrieved from: www.trainandeducate.com/docs/ipte_te2.pdf (7 May, 2011)
Health Education Board for Scotland (HEBS) (1999). Research for a Healthier Scotland: The Research Strategy for the Health Education Board for Scotland. Edinburgh: HEBS
Kiger A.M. (1995). Teaching for Health, 2nd edn. Edinburgh: Churchill Livingstone
Kim, T. and Axelrod, S. (2005): Direct Instruction: An Educators’ Guide and a Plea for Action. The Behaviour Analyst Today, 6(2), 111
Knowles, M. S. (1984) Andragogy in Action. Applying modern principles of adult education. San Francisco: Jossey Bass
Leonard, D.C. (2002). Learning Theories A–Z. Greenwood: Palgrave
Pirie P.L. (1999) Evaluating community health promotion programs. London: Sage
Polito, T. (2005). Educational Theory as Theory of Culture: A Vichian perspective on the educational theories of John Dewey and Kieran Egan. Educational Philosophy and Theory, 37(4), 205-234
Tones K. & Tilford S. (1994). Health Education: Effectiveness, Efﬁciency & Equity, 2nd edn. London: Chapman & Hall
Whitehead, D. (2001a). A stage planning programme model for health education/health promotion practice. Journal of Advanced Nursing, 36, 311–320.
Whitehead, D. (2001b). A social cognitive model for health education/ health promotion practice. Journal of Advanced Nursing, 36,417–425.
Whitehead, D. (2003). Evaluating health promotion: a model for nursing practice. Journal of Advanced Nursing, 41(5), 490–498