Narrative pedagogy in nursing ed used to teach tough topics

The nursing field faces a number of challenges, including a growing population of hospitalized patients who are older and more acutely ill, diminished financial resources for healthcare centers, and the need to stay current with rapid advances in medical knowledge and technology. These challenges are complicated by an existing shortage of nurses, an aging nurse workforce, a shortage of nursing faculty members, and prospects of a worsening nurse shortage.

To help prepare nursing students to meet these challenges, nursing educators must continually realign curricula, approaches and programs with the requirements of nursing practice environments. Employers need nurses who can work effectively in inter-professional teams in a variety of healthcare settings. Those nurses increasingly need to step up into leadership positions within the healthcare field.

One approach developed over the last decade is utilizing narrative pedagogy in nursing education. More simply termed, it's storytelling, to teach complex clinical topics. Narrative pedagogy is an approach that evolves from the lived experiences of teachers, clinicians, and students.

It is more than just what is taught; it is how it is taught that creates the necessary changes in attitudes and behaviors. Lecture alone can rarely develop all of these competencies.

What is narrative pedagogy in nursing education?

Narrative pedagogy is used as a means of complementing a more conventional method of teaching and learning. By focusing attention on the human element of health care, teachers and learners together explore meanings from the interpretation of stories. Learners consider the emotional experiences of participants, challenging conventional wisdom and otherwise constructing their new understandings and perspectives.

Storytelling within the classroom has taken the form of literature and film, among other forms of presentation. Individual stories are embedded within the narrative. Stories are used to highlight the human response to illness and health. Interpreting those stories is a reflective practice for analyzing these real-world situations. In this reflective practice within narrative pedagogy, students systematically think about one's actions and responses to improve future actions and responses.

How does this storytelling process work?

Learners begin by noticing what is happening in a clinical situation, interpreting what it means, responding to the situation and then reflecting on how to improve. By considering the situation from a variety of perspectives, learners are helped to develop clinical judgment.

Narrative pedagogy is designed to encourage a spirit of inquiry to continually ask questions and to seek evidence-based best practices; to assess patient needs and preferences for patient-centered care; and to increase situational awareness of the potential for error.

In this video, "Digital Storytelling: An Innovative Technological Approach to Nursing Education," students created a 5-minute narrated digital story using VoiceThread technology. Through the writing and sharing of digital stories, they embraced the personal and complex nature of palliative care.

Image credit: Journal of Medical Internet Research

Resources to implement narrative pedagogy in nursing

While slow to be adopted as a standard practice in nursing education, narrative pedagogy has been effectively used in nursing education classrooms. Research studies have indicated that faculty were eager to implement the process but needed resources and support to help change the prevailing paradigms.

Modern technology has opened up a new range of electronic narratives - such as virtual simulation. A multimedia online simulation of a typical community can achieve the goal of providing a suitable narrative. Using real people and real world settings, the stories of people in this community are related and used to support narrative pedagogy.

Co-developed by Laerdal Medical and Wolters Kluwer, vSim for Nursing was designed to provide needed resources to help develop clinical reasoning skills, competence, and confidence in nursing students through evolving clinical stories of patient encounters. As an interactive, personalized simulation experience, vSim increases recall and the transfer of learning through visual, auditory, and other narrative pedagogy cues.

Designed to simulate real nursing scenarios, vSim allows students to interact with patients in a safe, realistic environment, available anytime, anywhere. Each course area includes a variety of patient diagnoses and situations requiring complex decision-making and reasoning.

These guides provide strategies for use of vSim for Nursing in programs across all types of nursing education.

Preparing students to become competent, confident nurses requires far more than helping them master facts and information. They need learning experiences that teach them to think on their feet and use their clinical reasoning skills to make sound clinical decisions in the midst of conflicting priorities.

Discover the best ways to build clinical reasoning skills in your students through vSim for Nursing.