NURS 8544 Week 3 Learner Analysis Paper Example

Thirty Learners Before the Method: A Learner Analysis of a Second-Year Prelicensure Cohort by Prior Knowledge, Held Beliefs and Working Conditions

Student Name

College of Nursing, Walden University

NURS 8544: Strategies for Teaching Innovations in Nursing Education

Instructor Name

Month Day, Year

Thirty Learners Before the Method: A Learner Analysis of a Second-Year Prelicensure Cohort by Prior Knowledge, Held Beliefs and Working Conditions

Purpose and Cohort

Instructional design texts place learner analysis before the choice of method, because a strategy fitted to an imagined audience may suit no one in the room (Smith & Ragan, 2005). This analysis profiles the thirty second-year learners about to begin the adult health course in the second year of a composite two-year registered nursing program, in preparation for a unit on oxygenation and respiratory failure. The cohort is described, not named, and all figures are reported as counts of learners rather than percentages, since a percentage of thirty can make one learner look like a trend.

The profile draws on four kinds of evidence, kept separate because each answers a different question: prior coursework, a short entry probe, documented beliefs and the conditions under which learners study. Each section ends with one implication for instruction, stated as a constraint the later design must respect rather than as a plan.

Prior Coursework: What Was Covered

All thirty learners completed anatomy and physiology I and II, microbiology and the first-semester fundamentals and medical-surgical courses. Their transcripts show that gas exchange, the oxygen-hemoglobin dissociation curve and the control of breathing were formally covered in physiology, and oxygen delivery devices were covered in fundamentals. Twenty-two took physiology at this college; eight transferred it from three other institutions, whose syllabi show the dissociation curve was covered at two of them.

Coverage, however, is not retention. A transcript shows that a topic was taught and assessed at some point, often more than a year ago, not that learners can use it now. Ambrose et al. (2010) distinguish prior knowledge that is insufficient, inappropriate or inaccurate, and transcripts cannot tell these apart.

Implication: The design cannot assume physiology is available simply because it was covered; it must check what was retained.

Entry Probe: What Was Retained

To check retention, learners completed a six-item ungraded probe in the first week, before any teaching on oxygenation. Twenty-nine of thirty responded. The results were uneven.

Twenty-five learners correctly identified the normal range for oxygen saturation, and twenty-three correctly matched common delivery devices with their approximate oxygen concentrations. Only nine could explain, in one sentence, why a patient with a normal saturation could still be poorly oxygenated at the tissue level, and only seven correctly predicted the effect of fever and acidosis on hemoglobin's release of oxygen. Twelve left that item blank. Learners therefore retained facts that are used every day in clinical practice, such as ranges and devices, but not the physiological relationships needed to reason about a deteriorating patient.

Implication: Instruction must rebuild the relationships, particularly the dissociation curve, rather than review the facts, which most learners already hold.

Held Beliefs: What Learners Wrongly Believe

Two beliefs appeared in the probe's written answers often enough to matter. The first, written in some form by eleven learners, was that oxygen saturation measures how much oxygen the blood contains, so a normal saturation means the patient has enough oxygen. The second, written by eight, was that giving more oxygen is always safe and always helps. Physiology educators have recorded similar misconceptions among undergraduates, including confusion between the amount of oxygen carried and the percentage of hemoglobin saturated (Michael et al., 1999).

Both beliefs are reasonable conclusions from clinical experience. In the first semester, learners mostly saw saturation used as a quick check, and they saw oxygen applied whenever a patient seemed unwell. Because the beliefs are drawn from experience, they are likely to be held with confidence and to survive teaching that simply states the correct view.

Implication: The design must create a situation in which each belief makes a wrong prediction that learners can see, rather than relying on correction by explanation.

Conditions: How Learners Study

A short anonymous survey in the first week described the conditions under which learners study. Twenty-one work for pay outside the program, fourteen of them more than twenty hours a week. Eleven drive more than forty minutes each way to campus. Six reported that English is not the language they read most comfortably. Nineteen said they study mainly on a phone, during breaks or commutes.

These are not excuses or problems to be solved by the course. They are data about what the design can ask of learners. Adult learners bring obligations that shape when and how they learn, and instruction that ignores those obligations tends to lose them (Knowles et al., 2015). A design requiring long pre-class reading would be completed by few. Dense text with unfamiliar idioms would be harder for six learners than the content warrants.

Implication: Out-of-class work must be short, usable on a phone and written in plain language; the reasoning work should happen in class time.

What the Profile Adds Up To

Taken together, the evidence describes a cohort that knows the facts of oxygenation, has lost the physiology that connects them, holds two confident misconceptions drawn from experience and has limited time outside class. That profile rules out several strategies before any are considered. A lecture reviewing ranges and devices would repeat what learners already know. A reading-heavy flipped design would fail on time. A strategy that simply explains the dissociation curve again would leave the misconceptions in place. The strategy chosen later will need to rebuild one relationship at a time, make the misconceptions fail in front of learners and do its heavy work in class.

The profile also changes how the cohort's first-week results should be read. A low score on the probe's physiology items is not evidence that these learners are weak; it is evidence that the relationships were taught once, assessed once and then not used for a year. That reading points the design toward retrieval and use, not toward remediation, and it keeps the profile from becoming a list of deficits. The profile has limits. The probe was short and ungraded, so some learners may not have tried their hardest. The survey relied on self-report. And thirty learners cannot represent other cohorts. The profile should be repeated with the next cohort before the design is generalized.

References

Ambrose, S. A., Bridges, M. W., DiPietro, M., Lovett, M. C., & Norman, M. K. (2010). How learning works: Seven research-based principles for smart teaching. Jossey-Bass.

Knowles, M. S., Holton, E. F., III, & Swanson, R. A. (2015). The adult learner: The definitive classic in adult education and human resource development (8th ed.). Routledge.

Michael, J. A., Richardson, D., Rovick, A., Modell, H., Bruce, D., Horwitz, B., Hudson, M., Silverthorn, D., Whitescarver, S., & Williams, S. (1999). Undergraduate students' misconceptions about respiratory physiology. Advances in Physiology Education, 277(6), S127-S135. https://doi.org/10.1152/advances.1999.277.6.S127

Smith, P. L., & Ragan, T. J. (2005). Instructional design (3rd ed.). Wiley.