Kantar Lina D, Ezzeddine Sawsan, Rizk Ursula
Rafic Hariri School of Nursing, American University of Beirut, Lebanon.
Nurse Educ Today. 2020 Dec;95:104595. doi: 10.1016/j.nedt.2020.104595. Epub 2020 Sep 11.
The complexity of the learning environment and intricacy of nursing tasks make it difficult for students to learn without the assistance of an expert. Teaching in the zone of proximal development (ZPD) aims at positioning learners in the zone of what they can do and develop with assistance to reach full potential and independence. ZPD is deemed essential to understand how teaching and learning take place; however, its implications for clinical educators are limited and need further exploration.
This research study aimed at exploring the instructional strategies that preceptors use to guide and support the development of undergraduate nursing students, from what they are capable of doing with assistance to what they can become and do independently.
The qualitative multiple case study research design was used to gain insights into the teaching experiences of 18 nurse preceptors situated in three recognized hospitals in Lebanon.
Each preceptor was interviewed face-to-face using questions that were developed from a three-hour observation. Vygotsky's learning principles formed the reference point for this study. Analytic induction and constant comparison of preceptors' responses were applied throughout the study to unravel assisted strategies that target the potential learning zones of the student.
Three assumptions emerged from the data to underpin the preceptors' assistive strategies that help move learners from a cannot-do-level to can do independently. The assumptions are: (1) learning from clinical experience, (2) teaching beyond student ability, and (3) teaching for autonomy. In-depth analysis of both assumptions and strategies that focus instruction within each student's ZPD converged on a framework of three constructs: differentiated instruction, instructional scaffolding, and influencing a positive learning environment.
It is imperative that clinical educators be most receptive to instruction that targets the student's ZPD, as the zone represents a potential phase in student learning. This study provides a ZPD framework for intensifying learning gains from clinical practice.
学习环境的复杂性和护理任务的错综复杂使得学生在没有专家协助的情况下难以学习。在最近发展区内教学旨在将学习者置于他们在他人协助下能够做到的区域，以充分发挥潜力并实现独立。最近发展区被认为对于理解教学过程至关重要；然而，其对临床教育工作者的影响有限，需要进一步探索。
本研究旨在探索带教老师用于指导和支持本科护理学生发展的教学策略，即从他们在协助下能够做到的事情到他们能够独立做到和完成的事情。
采用定性多案例研究设计，以深入了解黎巴嫩三家知名医院的18位护士带教老师的教学经验。
使用从三小时观察中得出的问题对每位带教老师进行面对面访谈。维果茨基的学习原则构成了本研究的参考点。在整个研究过程中，运用分析归纳法和对带教老师回答的持续比较，以揭示针对学生潜在学习区域的辅助策略。
数据中出现了三个假设，以支撑带教老师的辅助策略，这些策略有助于学习者从无法做到的水平转变为能够独立完成。这些假设是：（1）从临床经验中学习，（2）超越学生能力进行教学，（3）为自主学习而教学。对聚焦于每个学生最近发展区内教学的假设和策略的深入分析，汇聚成一个由三个结构组成的框架：差异化教学、教学支架和营造积极的学习环境。
临床教育工作者必须最能接受针对学生最近发展区的教学，因为该区域代表了学生学习的一个潜在阶段。本研究提供了一个最近发展区框架，以增强临床实践中的学习效果。
