1. Woo Hoo…I’m Finally Here Now….what can I do to get the most out of my learning?

2. Oh my…we’re not in Kansas anymore Dorothy How does the graduate program at Frontier look different from your previous learning endeavors?

3. Adult Learners… …bring values, beliefs and assumptions to the classroom to create the lens through which new information is viewed and through which one makes sense of the world.

4. Transformative Learning Adult learners experience a process of development that “is not a succession of age related steps and stages, but instead results from transformations of perspective in response to unexpected events or disorienting dilemmas” (Meziro, 1990)

5. Let’s think about how we learn: We interpret new knowledge in our own way Based largely on our sense experiences We all have our own frame of reference for interpreting the world Originates in how we were raised, the culture in which we lived, and what we have previously learned We all have unique ways of knowing, believing and feeling This is what we refer to as “meaning perspectives” It feels safe to hold on to old meaning perspectives because doing so avoids feelings of anxiety and a loss of self confidence. (Williams, 2001)

6. Adult learners may feel conflicted with the acquisition of new knowledge. “But wait a minute….I’ve always done it this way and I’m pretty sure that’s the right way to get the job done!”

7. This is what we call a distortion in meaning perspective Unquestioned, unexamined and perhaps unconscious assumptions that limit our openness to change, growth, and personal/professional development. As young learners we accepted what we heard and read as “the truth” As adults, through reflective judgment, we discover that knowledge is a product of inquiry and reflection.

8. So let’s go back to that notion of “transformative learning” Transformative learning allows students to critically evaluate old ways of knowing and transform their thinking in such a way that they gain new understandings of the world around them.

9. As advanced practice nurses we must acquire specialized knowledge for safe clinical practice…

10. …but to remain competent we must also continuously engage in self conscious reflection and self critique (critical reflection) (Schon, 1995)

11. So how do we engage in transformative learning? Through reflection: “The process of internally examining and exploring an issue of concern, triggered by an experience, which creates and clarifies meaning in terms of self and results in changed conceptual perspective” (Boyd & Fales, 1983)

12. Reflection (Mezirow, 1990) Content Reflection: Examining the content or description of an issue or problem (often asks “what”) Process Reflection: Examining the problem solving strategies that are being used (often asks “how”) Premise reflection (AKA critical reflection): Questioning the problem itself (often asks “why”)

13. Three stages of reflection (Williams, 2001) Stage 1 is stimulated by an event or situation that creates an awareness of some sort of emotional response (puzzlement, surprise, discomfort) Stage 2 involves analysis of the situation as it relates to current knowledge, perceptions and assumptions. Stage 3 requires continued analysis of the situation and a revision of assumptions or meaning perspectives, reintegration of new knowledge, and reorientation of new meaning perspectives that create a sense of balance (comfort).

14. So why is this kind of reflection important for me as a graduate student? During the next few years you will learn many new ideas that will challenge old ways of thinking and knowing….ideas that may make you feel uncomfortable…and knowledge about evidence that you’ll need to use in practice.

15. In addition to making you feel uncomfortable, knowledge from new perspectives may at times seem hard to grasp.

16. Critical reflection allows you to step back…examine old assumptions…identify new ways of knowing…and gain a sense of accomplishment and self confidence as you implement new knowledge in practice.

17. Here’s a real life example of how this works: Before I went to midwifery school I was a darn good labor and delivery nurse….I pretty much knew everything I needed to know about the best way to get a woman delivered.

18. I could get a woman to pull her legs back further, and push longer with every contraction than any other nurse on the unit. I was a master at counting to 10 (and getting mothers to hold the push for the full 10 seconds).

19. I knew how to use all the latest technology, and I used it to save the lives of mothers and babies. AND I was always able to get the doctor there at the right time.

20. Then I started learning about “woman centered childbirth”…how women are able to push without direction…about pushing and giving birth in non-supine positions….

21. And I began to wonder…. …could women really push without me telling them how…with my counting? …didn’t they need to be on their backs…with their legs pulled back…I’m pretty sure that’s the best way to do it? …had I been doing it wrong for all those years…is there a better way? …if they don’t need my direction, then what am I really there for…how can I give them support?

22. So I started to reflect: I started reading…and reading…and then I read some more And then I talked to experts (teachers and preceptors) Then I started using my new knowledge in practice

23. And most importantly… I started to journal about the transformation of my thinking. I needed a way to see the path my thinking had taken…where had it been…where was it now…and where was it headed?

24. Reflection through Journaling… Allows a private opportunity for adult learners to critique their practice (and learning) in terms of newly transformed meaning perspectives Allows adult learners to consciously reflect on the assumptions, biases, and values that contribute to distortions in meaning perspective (and discomfort) Allows learners to reflect on previous ways of knowing and believing Allows learners to track the progression of their thinking and knowing in new contexts…with new perspective (Ruland & Ahern, 2007)

25. Let’s give it a try! (on this slide, let’s provide them with some specific direction about their first journal entry…some question about their thoughts as they arrived on campus to start their journey)

26. References Mezirow, J. (1990). Fostering critical reflection in adulthood. San Francisco: Jossey-Bass. Ruland, J., & Ahern, N. (2007). Transforming student perspectives through reflective writing. Nurse Educator, 32(2), 81-88. Schon, D. (1995). The new scholarship requires a new epistemology. Change, 27, 26-34. Williams, B. (2001). Developing critical reflection for professional practice through problem-based learning. Journal of Advanced Nursing, 34(1), 27-34.