Adult nursing student Oliver Suppiah Cycle 1 observation reflection

As Nursing students, we were asked to observe two sessions run by one of our lecturers, Lee Roberts. One session was on chronic wounds, and the other was about living with a disability. The first session, chronic wounds, was a session heavy with physiology going into detail about the process involved in normal wound healing and how this can be disrupted. The second session was much more discursive, with a focus on understanding an empathising with the problems facing an individual with a disability.

During the sessions, me and my colleague sat in the lecture theatre near the back and timed our observation, so we had 30 minutes of note taking. Before the sessions, we met together to discuss the way in which we would set out our observation tables, as well as what categories we could use to streamline our notes. Additionally, we met with Lee and the lecturer also taking part in the observation, Dion Smyth. We met Lee and Dion twice, first to talk through what our expectations of the study were and what factors influence our own learning experience, and then a second time to reflect upon the observations and how the study affected our metacognition of the learning process.

I approached the study with the idea that I would be able to get an insight into my own experiences of learning, and with that in mind, I was anxious about what I might uncover within myself. My attention can stray with very little provocation, and having already experienced university once and deciding to leave that course, I wanted to know what changed in my attitude that has made me more engaged and successful on the Nursing course.

While reflecting on each aspect of my observation table in turn, I realised that there was a constant flow of question and answer within my own interpretation of the information presented. The disruption of this flow can be caused by my own preoccupation with questions I pose in my head, but more often is caused by my fixation on the distracting behaviour of other students. This led me to feeling disappointed with both my own ability to concentrate, and other students’ lack of awareness for their peers learning. Despite this, there was a sense of achievement gained by completing this cycle of the study through a positive approach shared by me and my colleague.

Instead of focusing on superficial aspects of the way the lecture was presented, like the nuances of how Lee spoke or whether the content was noteworthy, we primarily noted the diverse ways the information was structured and how the audience and Lee responded to this information. This meant that we moved away from subjective judgements, which can only be used to infer our individual personal opinions.

During our training session for the study, we also had a question and answer style interview that was recorded. These recordings were sent to us via email, and listening to these proved incredibly helpful when identifying the parts of our own history of learning that relate to studying nursing. This gave me the idea of working backwards from my own cognition of the learning process to develop a table with categories of observable aspects, which could then be used to organise the points noted during the sessions. This led to a more objective approach to the observation, but also revealed a specific benefit I found in both visually presented processes in flow charts and the benefits of linking theory and practice through case studies.

Before our first scheduled observation, Jay and I met to discuss the tables we prepared using our practice observations and our initial interview recordings. By connecting the innate observations while taking notes in our own lectures with the conversations we had about how our own perceptions change the way we process information, we helped each other vocalise our expectations of lectures and what could be done to avoid assessing the content of the lecture based on these. Through doing this though, we also began discussing criteria for observation.

With this idea of criteria, there became a way of fixating on aspects of the session that were best to reflect on, and this lead to the learning experience being treated in a reactive way. Straying away from non-biased reflection post-observation and putting more effort into immediately reflecting on the session was a poor choice, and as this was my own mistake it became difficult to shift the reflection back to the topic of future learning experiences and how to improve them.

To have made a more positive difference in my own learning and reflection, I could have spent some time with my colleague Jay discussing the feelings and benefits that came from the experience. We could have recorded this meeting and used it as a debrief, therefore giving us the opportunity to go over the specific aspects of the sessions that we felt aided the learning process and used this to add to our reflection.

However, by designing my observation table to give me a category specifically focused on personal experiences and situations encountered in practice, my reflection revealed an important learning outcome in our course related to imagining a case study and assessing the patient. This involvement of visualisation of a real-life scenario changes the way information is managed and further committed to memory. A poignant example of this was when Lee discussed the idea of how a student nurse is made to feel empowered when on placement, or rather the lack of empowerment we usually experience. As students we are often referred to as simply ‘the student’ without attention paid to our names, and the expectations on us are continually shifting while our locus of control is no longer internalised. This was then translated over to how a patient feels when in our care, and how if there is a hierarchy of control with students lower down within it, then patients that are stripped of their individuality and placed into an environment they have little to no control over must be the lowest tier of this hierarchy.

The awareness that this study will provide of the factors affecting nursing students can be used to assess the formation of new programmes for the nursing course. There are links that can be made between the practical applications that a nursing programme must include and the lectures that discuss them in a beneficial way, through case study prompts and the occasional theatrical presentation.

It would have been advantageous if the study could have recruited more student observers, as this would have led to a wider range of perceptions of the sessions, as well as further evidence that there is a massive benefit to promoting reflective writing as a tool for improvement of both academic engagement and practical skills development.

Coincidentally, our timeframe for completing this cycle of the study coincides with the end of our module, which also means that our module assessment is imminent. This comes in the form of a summative exam, and I can certainly see the benefits of the self-discovery I have encountered during this observational study. My revision is now more tailored towards visualising physiological processes and breaking these into staged systems that I can follow, almost like a fluid narrative story.

Unfortunately, I was not able to apply any of my categorising techniques to my notes as it would not work very well retrospectively. However, in the future I will organise my post-session notes into separate text and images, with flow charts and prompt questions to summarise and jolt my revision. For this exam revision though I have fashioned my own key word flow charts to use as flash points.

As a final point, the results of this study should be able to help influence the changes that will be made to the new Nursing programmes for all the fields being designed for September 2019. I am proud to be part of a course that pays close attention to the feedback given by students. With this in mind, I hope that the extent of the data and reflection given by the students that took part across the fields can further the awareness the faculty staff have of the student experience, and the intrinsic and extrinsic factors that are involved in this experience.