Learning Curve In Nursing Education

Concept of Learning Curve In Nursing Education

The Concept of Learning Curve In Nursing Education,Role of Nursing Educator to Teach Various Audience.

The Concept of Learning Curve In Nursing Education

    Learning curve is a common phrase used to describe how long it takes a learner to learn anything new. This phrase, however, often is used incorrectly when referring to learners who have acquired new knowledge (cognitive domain) or have developed new attitudes, beliefs, or values (affective domain). 

    Research, to date, supports the correct use of the term learning curve, also sometimes referred to as the experience curve theory, only in relation to psychomotor domain learning . The concept of the learning curve is similar to the stages of motor learning described in Chapter 3.

    McCray and Blakemore (1985) note that the learning curve “is basically nothing more than a graphic depiction of changes in performance or output during a specified time period” (p. 5). A learning curve shows the relationship between practice and performance of a skill. 

    It provides a concrete measure of the rate at which someone learns a task. In many situations, evidence of learning (improvement) follows a very productive and predictable pattern. Understanding the key concepts surrounding the learning curve is essential for any teacher who is approaching the teaching and learning process when it involves skill development.

    Although the learning curve concept has been used in business and industry to measure employee productivity since the early 1900s, a thorough search of the medical and nursing literature reveals little documentation that this concept was applied to skill practice until very recently. 

    The medical profession began to describe the application of this concept to the learning of surgical and other invasive techniques in the first decade of the 21st century (Gawande, 2002; Waldman, Yourstone, & Smith, 2003). 

    Since then physicians have realized the usefulness of the learning curve concept in determining how long it takes them to become competent in performing procedures using new technologies, such as simulators, laparoscopes, endoscopes, and robotic instruments (Eversbusch & Grantcharov, 2004; Flamme, Stukenborg  Colsman, & Wirth, 2006; Hernandez et al., 2004; Hopper, Jamison, & Lewis, 2007; Kruglikova, Grantcharov, Drewes, & Funch-Jensen, 2010; Manuel Palazuelos et al., 2016; Murzi et al. , 2016; Qiao et al., 2014; Resnic et al., 2012; Savoldi et al., 2009). 

      It is important to note that the learning curve can be skewed by the reliability of the performance. Any novice can occasionally perform a skill correctly (beginner's luck), but what counts is consistency in the progress that is key to actually learning the skill. As Atherton (2013) states, it is incorrect to use the cliché “steep learning curve” to imply that something is difficult to learn. In fact, the opposite is true. 

    As a learner practices a difficult skill, in almost all cases the line rises slowly, not quickly, over time. In other words, a steep, short learning curve indicates that the learner mastered a skill rapidly and easily.

    Lee Cronbach (1963) was an educational psychologist whose classic work provides the foundation to understanding the concept of the learning curve. Cronbach defines the learning curve, specifically related to psychomotor skill development, as “a record of an individual's improvement made by measuring his ability at different stages of practice and plotting his scores” (p. 297).

1. Negligible progress: Initially very little improvement is detected during this stage. This pre readiness period is when the learner is not ready to perform the entire task, but relevant learning is taking place. 

    This period can be relatively long in young children who are developing physical and cognitive abilities, such as focused attention and gross and fine motor skills, and in older adults who may have difficulty in perceiving key discriminations.

2.Increasing gains: Rapid gains in learning occur during this stage as the learner grasps the essentials of the task. Motivation may account for increased gains when the learner has interest in the task, receives approval from others, or experiences a sense of pride in discovering the ability to perform.

3. Decreasing gains: During this stage the rate of improvement slows and additional practice does not produce such steep gains. Learning occurs in smaller increments as the learner incorporates changes by using cues to smooth out performance.

4. Plateau: During this stage no substantial gains are made. This leveling off period is characterized by a minimal rate of progress in performance. Instead, the learner is making other adjustments in mastering the skill. The belief that there is a period of no progress is considered false because gains in skills can occur even though overall performance scores remain stable.

5. Renewed gains: The rate of performance rises again during this internship

6.And the plateau period has ended. These gains usually are from growth in physical development, renewed interest in the task, a response to challenge, or the drive for perfection. Approach to limit: During this stage progress becomes negligible. 

    The ability to perform a task has reached its potential, and no matter how much more the learner practices a skill, he or she is not able to improve. However, this is a hypothetical stage because individuals never truly stop learning. 

    More nursing research needs to be conducted on applying the learning curve concept to the teaching and learning of psychomotor skills. Such studies would help educators to improve their understanding of various dimensions of the teaching and learning process related to mastering skills. In relation to patient, staff, and student teaching, research might answer such questions as the following:

    Can a learning curve be shortened given the characteristics of the learner, the situation, or the task at hand? Why is the learning curve steeper, more drawn out, or more irregular for some learners than for others?

    Can we predict the learning curves of our students depending on their educational or experiential backgrounds? How many times, on average, does a particular skill need to be practiced to improve competency and ensure consistency of performance? What can we do from an educational stand point to influence the pace and pattern of learning that may result in earlier or more complete achievement of expected outcomes? 

    How can the learning curve concept be applied to improve staff performance, thereby increasing work satisfaction and productivity. decreasing costs of care, and improving the quality and safety of care? 

    Answers to these questions might provide new approaches for evidence-based practice changes for nurses involved in the teaching and learning process.Many advantages can result by applying concepts of the learning curve to patient teaching and staff and student education. Perhaps the most important understanding of this concept is the realization that the pattern and pace of learning are typically irregular. 

    The learning of any task is initially slow, then more rapid, inevitably decreases, reaches a plateau, and then increases again. After this point, a limit is reached when likely no more significant improvement is likely to be achieved. Understanding this phenomenon can help educators adjust their expectations (or deal with their frustrations) when different paces and patterns of learning occur in individuals as they attempt to master any psychomotor skill.

    When the teacher shares with patients, staff, and students that the amount of practice needed to improve performance is very individualized, these learners may find their frustrations are reduced and their expectations become more realistic. For example, a patient who is undergoing rehabilitation to learn how to walk again following an injury may easily become discouraged with the lack of progress he is making. This happens as the pace of learning varies over time. 

    Also, the patient may experience a time at the beginning or in the middle of the curve when he or she seems not to be learning at all. Educators can realistically support the learner if they understand that the pace and pattern of skill development are based on the concept of the learning curve.

Role of Nursing Educator to Teach Various Audience

    Nurse educators not only require knowledge and experience to teach various audiences of learners effectively but also need the clinical evidence to prove their teaching methods and interventions are effective. Evidence should be based on up-to-date research to help guide the nurse in the delivery of evidence-based care. 

    The nurse should identify the types of information needed in specific situations and be competent in accessing the appropriate databases to obtain the information and research necessary to carry out all aspects of the educator role. “This leads to an increased awareness for the need for appropriate information to provide best care, solve an identified clinical problem, or facilitate a change in practice” (Pierce, 2005, p. 236).

    Plenty of evidence has established the value and utility of behavioral objectives for teaching and learning. Also, numerous research studies in the psychology literature have substantiated the framework, known as the taxonomic hierarchy, for categorizing behaviors (cognitive, affective, and psychomotor) according to type (domain) and complexity (level of difficulty). 

    Furthermore, a body of knowledge is available on how to develop internally consistent teaching plans using these behavioral objectives to legally document and properly implement individual plans of care for patient education. Such plans are often mandated by accrediting bodies of health-care agencies and organizations.

    Although the use of learning contracts is a relatively new concept, educational psychologists have conducted developmental research that provides evidence of adult learners' need for independent, self-directed, problem centered, and participatory learning. In contrast, the concept of the learning curve although a term superficially and widely adopted by educators has not been well defined or well explored for its theoretical application to teaching and learning in the health professions. 

    Only recently has evidence been uncovered regarding its reliability and validity in patient and nursing education for psychomotor skill acquisition. Indeed, more research needs to be conducted in nursing to demonstrate that the learning curve concept is a useful principle for nurse educators to incorporate into the process of teaching and learning

    The major portion of this chapter focused on differentiating goals from objectives, preparing accurate and concise objectives, classifying objectives according to the three domains of learning, and teaching cognitive, affective, and psychomotor skills using appropriate teaching methods and instructional materials. Writing behavioral objectives accurately and effectively is fundamental to the education process. 

    Goals and objectives serve as a guide to the educator in the planning, implementation, and evaluation of teaching and learning. The communication of desired behavioral outcomes and the mechanisms for accomplishing behavioral changes in the learner are essential elements in the decision-making process with respect to both teaching and learning.

    Assessment of the learner is a prerequisite to formulating objectives. The teacher must have a clear understanding of what the learner is expected to be able to do well before selecting the content to be taught and the methods and materials to be used for instruction. Objectives setting must be a partnership effort engaged in both the learner and the teacher for any learning experience to be successful and rewarding in the achievement of expected outcomes.

    Also, this chapter outlined the development of teaching plans and briefly discussed learning contracts and the concept of the learning curve. Teaching plans provide the blueprint for organizing and presenting information in a coherent manner. Nurses need to develop skills in writing teaching plans that reflect internal consistency of all the components. 

    Learning contracts are an innovative, unique, patient centered alternative to structuring an adult learning experience, especially in the home and rehabilitation settings. They are designed to encourage learners to be self-directed, which increases their level of active involvement and accountability. 

    For the nurse, understanding the concept of the learning curve is essential to teaching psychomotor skills. More nursing research needs to be done to yield findings from evidence-based practice in applying the learning curve concept to patient care and staff and student education.