Concept Mapping Anemia: Transferring Ownership in Learning to the Nursing Student

The concept of teaching and learning in schools of nursing has transformed in the 21^st century. Several theories of learning are responsible for this change in educational perspectives. First, Ausubel’s meaningful learning theory describes the process of moving away from receptive learning where content is presented to the student in its final form, allowing no opportunity for knowledge expansion (Driscoll, 2005). Ausebel found that when students were required to rearrange content and integrate it into what they already know and understand, then the information can be transformed into more meaningful knowledge. The constructivist theory, influenced by over eighty years of work by philosophizers and theorists including Piaget, Bruner & Vygotsky, Dewey, Goodman, von Glasersfeld, and Kuhn, expanded on the active learning concept in that learners construct knowledge in an effort to make sense and of everything they have experienced. Constructivism not only encourages student ownership of the learning process but it also recognizes the importance of collaborative learning and problem scaffolding (Billings & Halstead, 2009; Driscoll, 2005).

Schools of nursing have been integrating different teaching strategies that encourage an active learning process. Concept mapping is an example of this teaching strategy that requires learners to organize information and demonstrate the linkage between concepts and subconcepts (Billings & Halstead, 2009). In a recent qualitative analysis on nursing student’s perceptions of concept maps conducted by Harrison and Gibbons (2013), it was found that concept mapping helped give a visual summary of what was learned as well as helped students to reflect on how the knowledge can be transferred from theory to clinical practice although some students found the learning process to be a little longer and more tedious. In a critical analysis of 24 quantitative studies that explored the benefits of concept mapping, Pudelko, Young, Vincent-Lamarre, and Charlin (2012) concluded that concept mapping was more effective if it was combined with collaborative learning, scaffolding, and feedback.

In a traditional pathophysiology or adult health classroom, students would often hear a lengthy PowerPoint lecture on hematology accompanied by an explanation of the many different individual types of anemia’s. The lecture would proceed from one type of anemia to the next without effort to distinguish the similarities and differences between each of them. In 2006, this author created a concept map for a pathophysiology course in order to compare and contrast each of the anemia’s and to highlight that “anemia” is a general term that encompasses many specific types of anemia’s with different etiologies. The concept map is a single 8 x 14 sheet of paper that puts the general concept of anemia in a circle right in the center of the page. Students are given a detailed set of instructions and then they divide into groups of 3-4 students. These student groups use multiple resources including textbooks and electronic resources to find the general symptoms of all types of anemia’s and they put this in the center circle. This circle is then connected to three smaller circles that demonstrate the three major causes of all anemia’s which are a) decreased red blood cell production, b) inherited disorders that decrease or destroy red blood cells, and c) extrinsic red blood cell loss or destruction (Copstead & Banasik, 2012). These smaller circles of major causes are connected to multiple boxes that surround each circle. Within these boxes, students fill in the different types of anemia’s that are in each of these categories. The different types of anemia’s included on the map are iron, folic acid, & B12 deficiencies, aplastic anemia, chronic renal failure, sickle cell, thalassemia, G6PD, hereditary spherocytosis, hemolytic disease in the newborn, antibody-mediated drug reactions, and acute blood loss. Specific information includes the pathophysiology of each anemia, the unique signs and symptoms seen only with that particular type of anemia, and the typical treatment options for that disease.

This concept map assignment has replaced the traditional lecture on hematology and it is completed during the regular class period. Students work in groups all over the classroom while the instructor interacts with each group and helps guide the learning activity. It typically takes nearly two hours to complete and students receive quiz credit for completing it. The concept map becomes their notes for this particular week of learning and that is what they study from for their unit and final exam. When the concept map is initially introduced to the students, they tend to have a look of panic and anxiety over having this as their only source of notes for the week. However, by the end of the class period, they recognize how useful the learning experience was and have often commented on the course evaluations that the hematology week ended up being their favorite content and they wished that there were other concepts that could be taught in similar fashion because it reduced the volume of material, but it also helped them make meaningful connections between all of the anemia’s. They felt like they no longer had to sit and memorize each anemia individually which resulted in disconnected thought processes. This concept map has been used successfully for 19 consecutive semesters and in that amount of time there has been no negative feedback on the concept map on the course evaluations. Furthermore, students score either equally as well or better on this content on the tests than in other areas of pathophysiology. It should be noted that this concept map has also been successfully implemented into the online and hybrid version of pathophysiology.

This concept map will demonstrate an active-learning, constructivist teaching strategy that enables students to take ownership of their learning experience and create more meaningful knowledge rather than just rote memory of disconnected details. As nursing schools attempt to implement more meaningful learning experiences into the curriculum, it is important to use evidence-based strategies that enhance the classroom environment and prepare the student to readily transfer the knowledge from theory into practice.

Billings, D. M., & Halstead, J. A. (2009).Teaching in nursing: A guide for faculty. (3^rd ed.). St. Louis, MI: Saunders Elsevier.

Copstead, L C., Banasik, J. L. (2012). Pathophysiology. (5^th ed.). St. Louis, MI: Saunders Elsevier.

Driscoll, M. P. (2005). Psychology of learning for instruction. (3^rd ed.). Boston: Pearson.

Harrison, S., & Gibbons, C. (2013). Nursing student perceptions of concept maps: From theory to practice. Nursing Education Perspectives 34(6): 395-399.

Pudelko, B., Young, M., Vincent-Lamarre, P., & Charlin, B. (2012). Mapping as a learning strategy in health professions education: A critical analysis. Medical Education 2012, 46: 1215-1225.